Departamento de Dermatologia - FM/MDT

URI Permanente desta comunidade

O Departamento de Dermatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP) objetiva capacitar o aluno para que reconheça as principais doenças dermatológicas por meio de exame semiológico, com aulas práticas e teóricas. Oferece programas de Pós-Graduação stricto sensu, em nível de mestrado e doutorado, voltados à capacitação de docentes e pesquisadores na área de dermatologia.

As linhas de pesquisa incluem: dermatologia infantil; dermatoses infecciosas e parasitárias; imunodermatologia, Imunomodulação experimental; imunopatologia da infecção pelo HIV; imunopatologia das imunodeficiências primárias, imunopatologia das imunodeficiências secundárias, infecciosas ou metabólicas; oncologia cutânea; terapêutica dermatológica clínica e cirúrgica.

Site oficial: http://www.dermatousp.com.br/

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article 0 Citação(ões) na Scopus
HTLV-1-Associated Myelopathy (HAM) Incidence in Asymptomatic Carriers and Intermediate Syndrome (IS) Patients
(2024) MARCUSSO, Rosa Maria do Nascimento; ASSONE, Tatiane; HAZIOT, Michel E.; SMID, Jerusa; FOLGOSI, Victor A.; ROSADAS, Carolina; CASSEB, Jorge; OLIVEIRA, Augusto C. Penalva de
Several studies suggest that HTLV-1 infection may be associated with a wider spectrum of neurological and clinical manifestations that do not meet diagnostic criteria for HAM. These conditions may later progress to HAM or constitute an intermediate clinical form: intermediate syndrome (IS), a mid-point between asymptomatic HTLV-1 carriers and those with full myelopathy. Thus, we determined the incidence of HAM cases in the HTLV-1-asymptomatic and IS patients, and the clinical/laboratory associated markers. A total of 204 HTLV-1-positive patients were included in this study, divided into two groups: Group 1, including 145 asymptomatic HTLV-1 subjects (ASY), and Group 2, including 59 patients with inflammatory clinical symptoms in more than three systems and a high proviral load (PVL). During a 60-month follow-up time, with the age ranging from 47 to 79 years, ten patients of the fifty-nine initially diagnosed as IS developed HAM (iHAM), and two patients of the initial 145 ASY developed HAM directly. Women were more prevalent in all groups. For the iHAM patients, the age ranged from 20 to 72 years, with a mean of 53 (+/- 15 SD). Older age was associated with the development of HAM, higher PVL and IS; however, there was no any specific symptom or clinical sign, that was associated with risk for iHAM. In conclusion, IS cases could be an early phase of development of HAM. These findings show the presence of higher incidence probabilities in our cohort than previously reported.
article 0 Citação(ões) na Scopus
Exanthematous Pustulosis Restricted to Striae Distensae
(2024) AVANCINI, Joao; NICO, Marcello Menta Simonsen
article 0 Citação(ões) na Scopus
Epidemiological, clinical, and genomic landscape of coccidioidomycosis in northeastern Brazil
(2024) EULALIO, Kelsen Dantas; KOLLATH, Daniel R.; MARTINS, Liline Maria Soares; DEUS FILHO, Antonio de; CAVALCANTI, Maria do Amparo Salmito; MOREIRA, Lucas Machado; TENORIO, Bernardo Guerra; ALVES, Lucas Gomes de Brito; YAMAUCHI, Danielle; BARROZO, Ligia Vizeu; III, George R. Thompson; NACHER, Mathieu; STAJICH, Jason E.; BENARD, Gil; BAGAGLI, Eduardo; FELIPE, Maria Sueli Soares; BARKER, Bridget M.; TRILLES, Luciana; TEIXEIRA, Marcus de Melo
Coccidioidomycosis, listed as a priority mycosis by the WHO, is endemic in the United States but often overlooked in Central and South America. Employing a multi-institutional approach, we investigate how disease characteristics, pathogen genetic variation, and environmental factors impact coccidioidomycosis epidemiology and outcomes in South America. We identified 292 cases (1978-2021) and 42 outbreaks in Piaui and Maranhao states, Brazil, the largest series outside the US/Mexico epidemic zone. The male-to-female ratio was 57.4:1 and the most common activity was armadillo hunting (91.1%) 4 to 30 days before symptom onset. Most patients (92.8%) exhibited typical acute pulmonary disease, with cough (93%), fever (90%), and chest pain (77%) as predominant symptoms. The case fatality rate was 8%. Our negative binomial regression model indicates that reduced precipitation levels in the current (p = 0.015) and preceding year (p = 0.001) predict heightened incidence. Unlike other hotspots, acidic soil characterizes this region. Brazilian strains differ genomically from other C. posadasii lineages. Northeastern Brazil presents a distinctive coccidioidomycosis profile, with armadillo hunters facing elevated risks. Low annual rainfall emerges as a key factor in increasing cases. A unique C. posadasii lineage in Brazil suggests potential differences in environmental, virulence, and/or pathogenesis traits compared to other Coccidioides genotypes. Coccidioidomycosis, a WHO-listed mycosis, is neglected in South America. Analysis of 292 cases in Brazil, often tied to armadillo hunting, unveils unique disease patterns, environmental factors and pathogen genetics causing the disease.
article 0 Citação(ões) na Scopus
Assessment of reflectance confocal microscopy for monitoring treatment of actinic keratosis and field cancerization with daylight photodynamic therapy
(2023) CAVALCANTE, Raquel Bandeira De Melo; VALENTE, Neusa Yuriko Sakai; FERREIRA, Paula Silva; NETO, Cyro Festa; TOREZAN, Luis
BackgroundActinic keratosis (AK) is the most common pre-malignant cutaneous lesion of the skin, often associated with field cancerization. Daylight photodynamic therapy (DL-PDT) is used as treatment, showing good histological results. Reflectance confocal microscopy (RCM) may be useful as a non-invasive, real-time approach to monitor treatment, however, there is a lack of data on the correlation between RCM and histopathological findings in AK patients treated with DL-PDT.ObjectivesTo correlate histological and RCM findings and evaluate the efficacy of DL-PDT in patients with AK and field cancerization treated with DL-PDT.Materials & MethodsPatients with field cancerization and a minimum of six AK lesions on the face were included in the study. A single session combining methyl aminolevulinate followed by two-hour daylight exposure of the face was performed. RCM and biopsy were performed before and after three months of the intervention to compare efficacy between patients using the Wilcoxon test, and concordance of the findings based on the different methods was analysed using the Kappa test.ResultsTwenty-four patients completed the study. An improvement in photodamage and a decrease in the number of AK lesions (45.3% reduction) was observed. Regression in atypia and dysplasia was observed via histopathology and RCM, however, there was poor agreement between the methods. No changes were observed after treatment for inflammation, fibroplasia and acantholysis.ConclusionConcordance between histological and RCM findings was poor, suggesting that RCM cannot replace the histopathological examination, however, it may be used as an adjuvant test for follow-up of patients. Despite this, DL-PDT proved to be an effective method for treating AK.
article 0 Citação(ões) na Scopus
Impact of climate change on atopic dermatitis: A review by the International Eczema Council
(2024) WANG, Sheng-Pei; STEFANOVIC, Nicholas; ORFALI, Raquel L.; AOKI, Valeria; BROWN, Sara J.; DHAR, Sandipan; EICHENFIELD, Lawrence F.; FLOHR, Carsten; HA, Alex; MORA, Camilo; MURASE, Jenny E.; ROSENBACH, Misha; SRINIVAS, Sahana M.; THYSSEN, Jacob P.; WEI, Maria L.; IRVINE, Alan D.; ABUABARA, Katrina
Atopic dermatitis (AD), the most burdensome skin condition worldwide, is influenced by climatic factors and air pollution; however, the impact of increasing climatic hazards on AD remains poorly characterized. Leveraging an existing framework for 10 climatic hazards related to greenhouse gas emissions, we identified 18 studies with evidence for an impact on AD through a systematic search. Most climatic hazards had evidence for aggravation of AD the impact ranged from direct effects like particulate matter-induced AD exacerbations from wildfires to the potential for indirect effects like drought-induced food insecurity and migration. We then created maps comparing the past, present, and future projected burden of climatic hazards to global AD prevalence data. Data are lacking, especially from those regions most likely to experience more climatic hazards. We highlight gaps important for future research: understanding the synergistic impacts of climatic hazards on AD, long-term disease activity, the differential impact on vulnerable populations, and how basic mechanisms explain population-level trends.
article 1 Citação(ões) na Scopus
State of the Art on the Role of Staphylococcus aureus Extracellular Vesicles in the Pathogenesis of Atopic Dermatitis
(2024) TORREALBA, Marina Passos; YOSHIKAWA, Fabio Seiti Yamada; AOKI, Valeria; SATO, Maria Notomi; ORFALI, Raquel Leao
Atopic dermatitis (AD) is a chronic and relapsing inflammatory cutaneous disease. The role of host defense and microbial virulence factors in Staphylococcus aureus skin colonization, infection, and inflammation perpetuation in AD remains an area of current research focus. Extracellular vesicles (EV) mediate cell-to-cell communication by transporting and delivering bioactive molecules, such as nucleic acids, proteins, and enzymes, to recipient cells. Staphylococcus aureus spontaneously secretes extracellular vesicles (SA-derived EVs), which spread throughout the skin layers. Previous research has shown that SA-derived EVs from AD patients can trigger cytokine secretion in keratinocytes, shape the recruitment of neutrophils and monocytes, and induce inflammatory AD-type lesions in mouse models, in addition to their role as exogenous worsening factors for the disease. In this review article, we aim to examine the role of SA-derived EVs in AD physiopathology and its progression, highlighting the recent research in the field and exploring the potential crosstalk between the host and the microbiota.
article 0 Citação(ões) na Scopus
Oral lupus erythematosus: Immunohistochemical evaluation of CD1a, CD21, CD123, and langerin expression in dendritic cells
(2024) MARQUES, Elisa Raquel Martins da Costa; HSIEH, Ricardo; LOURENCO, Silvia Vanessa; NICO, Marcello Menta Simonsen
Background: Dendritic cells participate in the pathophysiology of lupus erythematosus (LE), which are studied in systemic and cutaneous forms; however, little is known about their oral manifestations. Methods: The expressions of dendritic cell markers (including CD1a, CD21, CD123, and langerin) were investigated by immunohistochemistry technique. Sixty intraoral and lower lip LE lesions, and additional 10 control samples were collected from 2003 to 2019. They were topographically analyzed in the epithelium (EP), lamina propria (LP), epithelial junction (JUN), and deep perivascular (PV) areas. Results: The expression of CD1a was decreased in the EP (p = 0.003) and increased in the deep PV area (p = 0.002). Langerin immunostaining showed no significant decrease in EP (p = 0.944); however, it increased in LP (p = 0.012) and JUN (p = 0.006). CD21 was expressed in only two specimens (EP, p = 0.012; LP, p < 0.001; deep PV area, p = 0.018). CD123 expression increased in all topographies (EP, p < 0.005; LP, p < 0.001, JUN, p < 0.001; deep PV, p < 0.001). The comparison between vermilion and intraoral mucosa LE lesions suggested that sun-exposed sites showed higher expression of CD123 (EP, p = 0.024; LP, p = 0.047; JUN, p = 0.001). Conclusions: CD1a, langerin, and CD123 expressions were detected coincidently surrounding the inflammatory infiltrate in oral LE, suggesting that these cells may play an important role in immune response. Interestingly, plasmacytoid dendritic cells showed increased CD123 expression in sun-exposed site lesions, which point out a possible function in their pathogenesis. Further studies are needed to confirm this hypothesis.
article 0 Citação(ões) na Scopus
Cutaneous inflammasome driving ASC / gasdermin-D activation and IL-1β-secreting macrophages in severe atopic dermatitis
(2024) RAMOS, Yasmim Alefe Leuzzi; PEREIRA, Naiura Vieira; AOKI, Valeria; SOTTO, Mirian Nacagami; KAWAKAMI, Joyce Tiyeko; SILVA, Luiz Fernando Ferraz da; SATO, Maria Notomi; ORFALI, Raquel Leao
Atopic dermatitis (AD) is an inflammatory skin disease with intense pruritus, and chronic skin colonization by Staphylococcus aureus. To understand the inflammatory status in AD, we investigated the inflammasome complex, that activates ASC (Apoptosis-associated speck-like protein containing a CARD), caspase-1 and GSDMD (gasdermin-D), and production of IL-1 beta and IL-18. We aimed to evaluate the expression of the inflammasome pathway in the skin of adults with AD. Thirty patients with moderate to severe AD and 20 healthy controls were enrolled in the study. We performed the analysis of the inflammasome components NLRP1, NLRP3, AIM-2, IL-1 beta, IL-18, Caspase-1, ASC, GSDMD, and CD68 expression (macrophage marker) by immunohistochemistry and immunofluorescence. The main findings included increased expression of NLRP3, NLRP1 and AIM-2 at dermal level of severe AD; augmented IL-18 and IL-1 beta expression at epidermis of moderate and severe patients, and in the dermis of severe AD; augmented expression of ASC, caspase-1 and GSDMD in both epidermis and dermis of moderate and severe AD. We detected positive correlation between caspase-1, GSDMD and IL-1 beta (epidermis) and caspase-1 (dermis) and AD severity; NLRP3, AIM-2 and IL-1 beta, and NLRP3 with IL-18 in the epidermis; ASC, GSDMD and IL-1 beta, and NLRP3, AIM-2, caspase-1, and IL-18 in the dermis. We also evidenced the presence of CD68+ macrophages secreting GSDMD, ASC and IL-1 beta in moderate and severe AD. Cutaneous macrophages, early detected in moderate AD, have its role in the disease inflammatory mechanisms. Our study indicates a canonical activation pathway of inflammasomes, reinforced by the chronic status of inflammation in AD. The analysis of the inflammasome complex evidenced an imbalance in its regulation, with increased expression of the evaluated components, which is remarkably in severe AD, emphasizing its relevance as potential disease biomarkers and targets for immunomodulatory interventions.
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Prefácio
(2016) MOTA, André; MARUTA, Celina W.; FESTA NETO, Cyro; RIVITTI, Evandro A.; SANCHES JR., José Antonio; AOKI, Valéria