CAROLINA OLIVEIRA COSTA FECHINE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
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- Lichen planopilaris and frontal fibrosing alopecia: review and update of diagnostic and therapeutic features(2022) FECHINE, Carolina Oliveira Costa; VALENTE, Neusa Yuriko Sakai; ROMITI, RicardoLichen planopilaris and frontal fibrosing alopecia are primary scarring alopecias where diagnosis can be suggested by clinical and trichoscopy features, especially in the early stages, but scalp biopsy is the standard exam for definitive diagnosis. Frontal fibrosing alopecia is considered a variant of lichen planopilaris, as the histopathological findings are similar, with a perifollicular lymphohistiocytic infiltrate, sometimes with a lichenoid pattern. A thorough clinical examination, trichoscopy and photographic documentation are essential to assess the evolution and therapeutic response. To date, there are no validated treatments or guidelines for these diseases, but there are recommendations that vary with the individual characteristics of each patient. This article presents a comprehensive review of the literature, including an update on topics related to the diagnosis, follow-up, histopathological aspects and available treatments for lichen planopilaris and frontal fibrosing alopecia, highlighting their similarities, differences and peculiarities. (C) 2022 Sociedade Brasileira de Dermatologia.
- Areata-Like Lupus as a Clinical Manifestation of Cutaneous Lupus Erythematosus(2022) MORAIS, K. L.; SECCHIN, P.; ANZAI, A.; VERUSSA, M. J. M. C.; MUNCK, A.; FECHINE, C. O. C.; VALENTE, N. Y. S.; ROMITI, R.Introduction: Lupus erythematosus (LE) is a chronic autoimmune disease that frequently causes hair loss and scalp lesions. Hair loss can be scarring and nonscarring, diffuse, or patchy. The nonscarring patchy alopecia is usually related to systemic LE (SLE) and may simulate alopecia areata (AA), reason why it is named areata-like lupus. Our case was diagnosed with areata-like lupus but did not meet criteria for SLE. Case Report: A 63-year-old woman presented with irregular nonscarring patchy alopecia in the temporal and frontoparietal scalp. Trichoscopy showed exclamation mark hairs, vellus hairs, and sparse yellow dots. Histology revealed epidermal vacuolar interface dermatitis, lymphohistiocytic infiltrate around the bulbs of anagen follicles, and eccrine glands. Direct immunofluorescence showed deposits of C3, IgA, and IgG in the basement membrane zone. Discussion: Patients with cutaneous LE can also manifest as nonscarring patchy alopecia that is clinically similar to AA, despite the absence of systemic manifestations. Areata-like lupus is secondary to the lupus autoimmune infiltrate that affects the skin including the hair follicles. Trichoscopy, histology, and direct immunofluorescence are important to differentiate this form of alopecia from AA, which is believed to have a higher incidence in lupus patients.
- Sensitive Scalp and Trichodynia: Epidemiology, Etiopathogenesis, Diagnosis, and Management(2023) SOUZA, Emilly Neves; ANZAI, Alessandra; FECHINE, Carolina Oliveira Costa; VALENTE, Neusa Yuriko Sakai; ROMITI, RicardoSensitive scalp (SSc) is considered a sensitive skin on the scalp, with its particularities. Although it is not rare in the dermatological practice and the term is commonly present in personal care products, this entity is poorly investigated in the medical literature. The etiopathogenesis is still uncertain, and the sensitivity may be associated with hair loss. Clinical manifestations are subjective symptoms of pruritus, burning, pain, pricking, and/or trichodynia, often with scalp erythema. SSc can be triggered by several factors (endogenous or exogenous). The diagnosis is guided by the anamnesis, and there are still no specific trichoscopic features. Trigeminal trophic syndrome and postherpetic neuralgia are the main differential diagnosis to be considered. We organized the therapeutical approach in three steps: scalp care, topical and systemic treatment.
- Image Gallery: Unusual images of monilethrix: the eyebrows and the biopsy(2017) ANZAI, A.; MUNCK, A.; FECHINE, C. Costa; GAVIOLI, C.; VALENTE, N.; ROMITI, R.
- Frontal fibrosing alopecia associated with lichen planus pigmentosus: A multicentre retrospective descriptive analytical study of 104 patients(2023) BRITO, Flavia Oliveira Xavier de; ALMEIDA, Rita Fernanda Cortez de; MACHADO, Carla Jorge; LEMES, Luciana Rodino; DONDA, Andre Luiz Vairo; BLANCO, Aline; SILVEIRA, Aline Lucy Galavotti; MUNCK, Andreia; LIMA, Caren dos Santos; CANELA, Carolina Porto Cotrim; FECHINE, Carolina Oliveira Costa; OBADIA, Daniel Lago; PINTO, Giselle Martins; ALVES, Lorena Dourado; DIAS, Maria Fernanda Reis Gavazzoni; BENEZ, Marcela; RIGATTI, Marcelo; KADI, Nadia El; KAKIZAKI, Priscila; MINOTTO, Renan; FRATTINI, Sidney; RAMOS, Paulo Mueller; MELO, Daniel Fernandes
- Clinical and Histopathological Findings of Frontal Fibrosing Alopecia-Associated Lichen Planus Pigmentosus(2017) ROMITI, Ricardo; GAVIOLI, Camila Fatima Biancardi; ANZAI, Alessandra; MUNCK, Andreia; FECHINE, Carolina Oliveira Costa; VALENTE, Neusa Y. S.Background: Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia occurring mainly in postmenopausal women. A range of facial lesions have been described in FFA, such as lichen planus (LP) pigmentosus, red dots, facial papules, and perifollicular and diffuse erythema. These lesions can be the first sign of FFA. LP pigmentosus is a rare variant of LP. The first description of LP pigmentosus associated with FFA (in 2012) reported 22 cases of LP pigmentosus among 44 cases of FFA affecting South African patients. Methods: We reviewed 16 FFA patients with LP pigmentosus and the histopathological findings of the biopsy of LP pigmentosus in 9 patients. Results: Most patients had intermediate skin phototypes (III-IV; n = 10; 62%). The age at onset of LP pigmentosus ranged from 30 to 60 years. The most common histopathological findings were epidermal atrophy, basal cell degeneration, interfollicular inflammatory infiltrate and melanophages, and perifollicular changes. Other findings not previously described in LP pigmentosus were inflammation and interface changes on sweat duct epithelia (acrosyringium and superior dermal duct), and lichenoid perisebaceitis. Conclusions: Histology of our cases confirmed previous findings and showed a high incidence of perifollicular involvement with occasional changes affecting sebaceous and sweat glands. (C) 2017 S. Karger AG, Basel
- Cicatricial Alopecia with Particular Trichoscopic and Histopathological Features(2019) ROCCHETTO, Helena; FECHINE, Carolina Oliveira Costa; ANZAI, Alessandra; MUNCK, Andreia; ASSALIN, Adriana Rochetto; VALENTE, Neusa Yurico Sakai; ROMITI, Ricardo
- Image Gallery: Folliculitis keloidalis on white-skinned scalp vertex(2017) FECHINE, C. O. Costa; ANZAI, A.; VALENTE, N. Y.; ROMITI, R.
- Female Progressive Scalp Hair Loss Associated with Ovarian Thecoma(2019) MUNCK, Andreia; LOPES, Andressa Sato de Aquino; ANZAI, Alessandra; FECHINE, Carolina Oliveira Costa; VALENTE, Neusa Yuriko Sakai; ROMITI, Ricardo