WALTER BELDA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Dermatologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Cutaneous New World Leishmaniasis on a Port-wine stain birthmark(2014) CRIADO, Paulo Ricardo; VALENTE, Neusa Sakai; NODA, Aliene; BELDA JUNIOR, WalterWe present an interesting case report of two sarcoid-like lesions on a port-wine stain (PWS) birthmark in a Brazilian patient which on investigation proved to be cutaneous leishmaniasis.
- In situ immune response in human dermatophytosis: possible role of Langerhans cells (CD1a+) as a risk factor for dermatophyte infection(2019) REIS, Ana Paula Carvalho; CORREIA, Franciele Fernandes; JESUS, Thais Martins; PAGLIARI, Carla; SAKAI-VALENTE, Neusa Y.; BELDA JUNIOR, Walter; CRIADO, Paulo Ricardo; BENARD, Gil; SOUSA, Maria Gloria TeixeiraDermatophytosis is a cutaneous mycosis caused by a plethora of keratinophilic fungi, but Trichophyton rubrum is the most common etiological agent. Despite its high prevalence worldwide, little is known about the host defense mechanisms in this infection, particularly the in situ immune response. Using an immunohistochemistry approach, we investigated the density of CD1a+, factor XIIIa+ and CD68+ cells in the skin of dermatophytosis patients. Langerhans cells (CD1a+ cells) were significantly decreased in the epidermis of patients, both in affected and unaffected areas. In the dermis, however, no differences in the density of macrophages (CD68+ cells) and dermal dendrocytes (factor XIIIa+ cells) were observed. These results suggest that the decreased number of Langerhans cells may be a risk factor for development of dermatophytosis.
- Extensive long-standing chromomycosis due to Fonsecaea pedrosoi: Three cases with relevant improvement under voriconazole therapy(2011) CRIADO, Paulo Ricardo; CARETA, Mariana Figueiroa; VALENTE, Neusa Y. S.; MARTINS, Jose Eduardo Costa; RIVITTI, Evandro A.; SPINA, Ricardo; BELDA JR., WalterObjective: To evaluate voriconazole in the treatment of extensive cases of chromomycosis. Chromomycosis is a chronic infection, which is extremely difficult to eradicate, and is caused by dematiaceous (dark-colored) fungi which affect the skin and subcutaneous tissues, with Fonsecaea pedrosoi being the major etiologic agent. Drugs such as itraconazole, terbinafine, posaconazole and amphotericin B have been employed with variable results. Methods: We treated three Caucasian male patients (ages 44, 57 and 77 years), two were farmers and one a trash collector, with long-standing (20, 10 and 21 years of disease, respectively) and extensive chromomycosis (one lower limb affected, at least) due to Fonsecaea pedrosoi. All patients had received previous therapy with the formerly indicated drugs itraconazole and terbinafine for several months either without or with incomplete response. After that, we started treatment with voriconazole per os 200 mg twice a day. Results: The patients were treated with voriconazole for 12 months until there was clinical and mycological improvement. Clinical response was evident after 30-50 days. One patient developed visual abnormalities and tremors, and the voriconazole was reduced to 200 mg/day without impairment of the clinical and mycological response. The same patient presented photosensitive dermatitis after 12 months of therapy and the voriconazole was stopped. All patients showed elevations of serum gamma-glutamyl transpeptidase (GGT) during the treatment without clinical relevance. Moreover, our three patients obtained partial response with this therapy. Conclusions: This is the first report with a case series of chromomycosis treated with voriconazole. Despite its high cost, voriconazole is a safe and possibly promising drug for use on extensive chromomycosis refractory to conventional treatment.
- Topical Application of Imiquimod as a Treatment for Chromoblastomycosis(2014) SOUSA, Maria da Gloria Teixeira de; BELDA JR., Walter; SPINA, Ricardo; LOTA, Priscila Ramos; VALENTE, Neusa Sakai; BROWN, Gordon D.; CRIADO, Paulo Ricardo; BENARD, GilChromoblastomycosis is a subcutaneous mycosis that remains a therapeutic challenge, with no standard treatment and high rates of relapse. On the basis of our recent discoveries in mouse models, we tested the efficacy of topical applications of imiquimod to treat patients afflicted with this chronic fungal infection. We report results of treatment for the first 4 recipients of topical imiquimod, all of whom displayed a marked improvement of their lesions, both with and without concurrent oral antifungal therapy.
- TOLL-LIKE RECEPTORS (TLR) 2 AND 4 EXPRESSION OF KERATINOCYTES FROM PATIENTS WITH LOCALIZED AND DISSEMINATED DERMATOPHYTOSIS(2015) OLIVEIRA, Cristiane Beatriz de; VASCONCELLOS, Cidia; SAKAI-VALENTE, Neusa Y.; SOTTO, Mirian Nacagami; LUIZ, Fernanda Guedes; BELDA JUNIOR, Walter; SOUSA, Maria da Gloria Teixeira de; BENARD, Gil; CRIADO, Paulo RicardoThere are few studies on the role of innate immune response in dermatophytosis. An investigation was conducted to define the involvement of Toll-Like Receptors (TLRs) 2 and 4 in localized (LD) and disseminated (DD) dermatophytosis due to T. rubrum. Fifteen newly diagnosed patients, eight patients with LD and seven with DD, defined by involvement of at least three body segments were used in this study. Controls comprised twenty skin samples from healthy individuals undergoing plastic surgery. TLR2 and TLR4 were quantified in skin lesions by immunohistochemistry. A reduced expression of TLR4 in the lower and upper epidermis of both LD and DD patients was found compared to controls; TLR2 expression was preserved in the upper and lower epidermis of all three groups. As TLR4 signaling induces the production of inflammatory cytokines and neutrophils recruitment, its reduced expression likely contributed to the lack of resolution of the infection and the consequent chronic nature of the dermatophytosis. As TLR2 expression acts to limit the inflammatory process and preserves the epidermal structure, its preserved expression may also contribute to the persistent infection and limited inflammation that are characteristic of dermatophytic infections.
conferenceObject Analysis of the Expression of Toll-like Receptors 2 and 4 in Keratinocytes of Patients with Extensive Dermatophytosis due Trichophyton rubrum(2012) CRIADO, P. R.; OLIVEIRA, C. B.; VASCONCELLOS, C.; VALENTE, N. Y. S.; SOTTO, M. N.; LUIZ, F. Guedes; BELDA JUNIOR, W.Rationale There are few studies to concern the role of innate immune response in dermatophytosis, so we conducted an investigation to define the involvement of TLRs in the course of tinea corporis by T. rubrum. Methods We allocated 14 patients without primary or secondary immunosuppression with extensive dermatophytosis, defined as the ringworm on at least 3 body segments of the same patient. In each patient the skin were biopsied from the active edge of the tinea and normal skin distant at least 4 cm of the lesion. Other skin fragments (control skin) were obtained from cosmetic surgery and without tinea. We use immunohistochemical staining with antibodies for antigens TLR 2 and 4. Images were analyzed in Image Pro Plus program. Results The Wilcoxon Signed Ranks Test showed: (i) regarding the expression of TLR2 of patients with tinea, found on the skin surface, average percentage of the marked area of 24.36 (1-76) in skin with tinea and 39.77 (9-84) in normal skin, p 0.043; (ii) analysis of TLR4 expression in the epidermis of patients with tinea met index higher optical density in normal skin than in skin with tinea, average 111.21 (99.44 to 134.34) and 104.50 (97.76 to 113.82), respectively, p 0.028. Conclusions We found a lower expression of TLR2 and 4 in the skin with tinea compared to healthy skin of the same patients with extensive dermatophytosis, as well as a tendency toward higher expression of TLR2 in the healthy peripheral skin, which could explain the spread in extension, in these cases of tinea.