ALEXANDRE JACK DWAN

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 11
  • bookPart
    Alcoolismo
    (2015) TORQUATO JUNIOR, Marco Antonio Abud; PELLEGRINO, Érica Fernandes Costa; LEAL, Gustavo Carneiro Gomes; DWAN, Alexandre Jack; DANILA, Arthur Hirschfeld; CASELLA, Caio Borba; ZABA NETO, Alberto
  • article 0 Citação(ões) na Scopus
    Extensive scalp ulcer secondary to delusional infestation treated with antipsychotics and scalp reconstruction
    (2020) PINCELLI, M. S.; GUIMARARES, A. L. M.; MILCHESKI, D. A.; DWAN, A. J.; NICO, M. M. S.
  • article 1 Citação(ões) na Scopus
    Trigeminal trophic syndrome: an important simulator of discoid cutaneous lupus erythematosus - a case series
    (2020) RESENDE, Ludimila O.; DWAN, Alexandre J.; NICO, Marcello M. S.
    Trigeminal trophic syndrome occurs secondary to trigeminal nerve injury, leading to anaesthesia and paraesthesia, with consequent vigorous facial skin manipulation and lesion production, simulating other facial diseases such as ulcerative discoid lupus erythematosus, tumours and other artificially produced lesions. Ulceration and destruction of the ala nasi is a typical feature besides scratching end excoriations in the cutaneous segment affected. In this series, we present the features of five patients with trigeminal trophic syndrome, highlighting possible confusion with cutaneous lupus. Differential diagnoses, including discoid lupus erythematosus, are discussed, as well as possible treatment modalities.
  • bookPart
    Interconsulta em dermantologia
    (2021) DWAN, Alexandre Jack; CALDERONI, Douglas Motta; NICO, Marcello Menta Simonsen; MINATOGAWA-CHANG, Taís Michele
  • article 0 Citação(ões) na Scopus
    Extraordinary Findings in a Case of Self-inflicted Cutaneous Lesions
    (2017) CANUTO, Maria Julia; MARTINS, Ana Claudia Grizzo Peres; DWAN, Alexandre Jack; NETO, Cyro Festa; NICO, Marcello Menta Simonsen
  • article 6 Citação(ões) na Scopus
    Ointment Pseudo-Cheilitis: A Disease Distinct From Factitial Cheilitis. A Series of 13 Patients From Sao Paulo, Brazil
    (2019) NICO, Marcello Menta Simonsen; DWAN, Alexandre Jack; LOURENCO, Silvia Vanessa
    Background: The terms exfoliative cheilitis, factitial cheilitis, and morsicatio labiorum are used to describe self-inflicted lesions of the lip. Objective: Here we report and analyze clinical, pathological, and therapeutic data on 13 patients with a form of factitial cheilitis that we believe should be considered a separate entity. Results: Eight patients were male and 5 patients were female. All patients reported pain and presented with crusts consisting of dried saliva and topical medications adherent to the surface of the lips. These patients expressed great concern with their condition, and reported several previous, ineffective treatments. Simple reassurance only was not effective; saline compresses alleviated symptoms for a few patients. Most patients were lost to follow-up. Biopsies were not performed on all patients. Conclusion: This particular type of cheilitis artefacta has been previously described, but some features described herein are new and allow a specific approach: patient's behavior, the ""protrusion sign,"" and possible improvement with antidepressants. For these cases, we propose the term ointment pseudo-cheilitis because it comprises the nature of the attached material and the lack of true inflammation. Further psychiatric characterization is a logical next step in further characterizing this difficult-to-treat condition.
  • article 2 Citação(ões) na Scopus
    Delayed Brain Cyst Formation After Gamma Knife Anterior Capsulotomv
    (2021) KASABKOJIAN, Stephanie Toscano; DWAN, Alexandre Jack; MAZIERO, Maria Paula; SALLES, Antonio de; GORGULHO, Alessandra; MIGUEL, Euripedes Constantino; VATTIMO, Edoardo Fillipo de Queiroz; LOPES, Antonio Carlos
    BACKGROUND: Gamma Knife ventral anterior capsulotomy is an effective option to treat refractory obsessive-compulsive disorder. Although well tolerated, complications can develop years after radiosurgery. We describe a case in which abnormal complications induced by very high doses of radiation evolved. CASE DESCRIPTION: A 55-year-old man with refractory obsessive compulsive disorder was treated with Gamma Knife ventral anterior capsulotomy using a dose of 180 Gy. His obsessive-compulsive symptoms improved, but his condition evolved with a manic episode, cognitive memory changes, visual hallucinations, confabulation, and frontal lobe symptoms. Magnetic resonance imaging showed brain edema in the left hemisphere and a 6-mm brain cyst in the right hemisphere at postoperative month 20. CONCLUSIONS: This case shows the consequences of affecting more fibers related to the anterior frontal region than intended with a radiosurgical procedure and illustrates the importance of careful clinical and imaging follow-up after Gamma Knife ventral anterior capsulotomy.
  • bookPart
  • article 1 Citação(ões) na Scopus
  • article 0 Citação(ões) na Scopus
    Delusional infestation treated with risperidone: a series of 27 patients
    (2024) GUEDES, Nycolle L. K. O.; DWAN, Alexandre J.; GERLERO, Paula; NICO, Marcello M. S.
    Background Patients with delusional infestation (DI) frequently refuse to be treated with psychoactive drugs. In the past, pimozide was commonly used as a first-line agent but is now prescribed more rarely. Risperidone was first used to treat DI in 1995. A recent review identified 12 studies that evaluated the use of risperidone in 43 patients with DI.Objectives To study the characteristics of and therapeutic results in patients with DI treated with risperidone at a university medical centre in Sao Paulo, Brazil.Methods We performed a retrospective study of patients with DI treated with risperidone at a dermatological university clinic since 2016. Records were reviewed for personal data and findings related to treatment.Results Twenty-seven patients were studied (20 women and 7 men). The maintenance dose of risperidone varied from 1 mg three times weekly to 8 mg daily. Control of symptoms was achieved in the majority of patients. A reduction in dosage due to side-effects was seen in four patients; risperidone had to be switched to another antipsychotic in three cases, despite a good response. Only one patient did not respond to risperidone.Conclusions Risperidone is an effective, well-tolerated and safe treatment for delusional parasitosis. Adequate follow-up is mandatory in order to obtain long-term control of symptoms. Patients with delusional infestation (DI) frequently refuse to be treated with psychoactive drugs. Risperidone was first used to treat DI in 1995. A recent review identified 12 studies evaluating risperidone, with a total of 43 patients with DI. We studied the characteristics and therapeutic results in 27 patients with DI treated with risperidone in a university medical centre in Sao Paulo, Brazil. Control of symptoms was achieved in the majority. Risperidone is an effective, well-tolerated and safe treatment for DI. Adequate follow-up is mandatory to obtain long-term control of symptoms.