NEUSA YURIKO SAKAI VALENTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
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- Histopathological and clinical evaluation of chronic spontaneous urticaria patients with neutrophilic and non-neutrophilic cutaneous infiltrate(2018) MARTINS, Cintia Freitas; MORAIS, Karina Lopes; FIGUEROA, Pamela; DIAS, Natasha Favoretto; VALENTE, Neusa Sakai; MARUTA, Celina Wakisaba; CRIADO, Paulo RicardoBackground: Chronic urticaria has an expressive prevalence in general population, especially in adults, and is defined by the presence of intermittent hives for six weeks or longer. Our study aims to characterize the histological patterns of chronic spontaneous urticaria, based on the inflammatory cell infiltrate, and correlate them to laboratory exams. Methods: It was performed a retrospective analysis of laboratory, histopathology and direct immunofluorescence data of 93 patients with chronic urticaria. For histopathological analysis, cell count was performed in four fields at high magnification (x400) for each specimen. The resulting cell count medians were submitted to statistical analysis and, then, were correlated to laboratorial findings. Results: We found a female predominance (76.34%) of chronic urticaria cases, and an average age of 42.5 years (SD +/- 15). Two histological groups were distinctive: 1) chronic urticaria with predominance of neutrophils or eosinophils - N (%) = 39 (42.4%) - and 2) chronic urticaria with predominance of lymphocytes - N (%) = 53 (57.6%). There was not significant correlation between histological groups and laboratorial tests. Moreover, direct immunofluorescence was positive in 21 (33,87%) from 62 patients. Conclusions: There is not enough scientific evidence to support neutrophilic urticaria as a solid, separate entity.
- Viremia and viruria of trichodysplasia spinulosa-associated polyomavirus before the development of clinical disease in a kidney transplant recipient(2019) PIERROTTI, Ligia Camera; URBANO, Paulo Roberto Palma; NALI, Luiz Henrique da Silva; ROMANO, Camila Malta; BICALHO, Camila da Silva; ARNONE, Marcelo; VALENTE, Neusa Sakai; PANNUTI, Claudio Sergio; DAVID-NETO, Elias; AZEVEDO, Luiz SergioTrichodysplasia spinulosa (TS) is a rare disease associated with immunosuppression and induced by a polyomavirus denominated Tricodisplasia Polyomavirus (TSPyV). We report a case of TS 6 months after kidney transplantation in a 65 years-old woman under immunosuppression therapy with prednisone, mycophenolate and tacrolimus. The patient developed follicular papules on the face with a thickening of the skin and alopecia of the eyebrows, leading to distortion of the face and a leonine appearance characteristic of the disease. The skin biopsy confirmed the clinical diagnosis and the presence of TSPyV DNA in the skin was detected. Staining for SV40 was positive. Immunosuppression was changed: mycophenolate was withdrawn, tacrolimus reduced and everolimus added. Intravenous cidofovir and later on leflunomide were added. Although the literature has reported clinical success with topical cidofovir, we were unable to use it because this drug is not available. There was an improvement of skin lesions and on cosmetic appearance. The patient had three rejections (one clinically diagnosed and two other biopsy proven), progressed with renal failure and graft loss. Retrospective analysis of stored urine and blood samples detected TSPyV DNA in some of those samples two months before the TS clinical development. This case highlights the TSPyV detection in blood and urine samples before the development of skin lesions.
- Leprosy in transplant recipients: report of a case after liver transplantation and review of the literature(2011) TRINDADE, M. A. B.; PALERMO, M. L.; PAGLIARI, C.; VALENTE, N.; NAAFS, B.; MASSAROLLO, P. C. B.; D'ALBUQUERQUE, L. A. C.; BENARD, G.P>Leprosy still is an important public health problem in several parts of the world including Brazil. Unlike the diseases caused by other mycobacteria, the incidence and clinical presentation of leprosy seems little affected in immunosuppressed patients. We report the first case, to our knowledge, of a liver transplant patient who developed multi-bacillary leprosy. The patient presented with papules and infiltrated plaques with loss of sensation suggestive of leprosy 3.5 years after living-related liver transplantation for autoimmune hepatitis. A skin biopsy showing non-caseating macrophagic granulomas, neuritis, and intact acid-fast bacilli on Fite-Faraco stain, confirmed the diagnosis of borderline lepromatous leprosy. The donor of the liver did not show any evidence of leprosy. During follow-up, the patient presented 2 episodes of upgrading leprosy type I reactions, 1 mild before leprosy treatment, and 1 moderate 3 months after receiving standard multi-drug treatment (rifampicin, clofazimine, and dapsone). These reactions were accompanied by increase in liver function tests, especially of canalicular enzymes. This reaction occurred despite the patient's triple immunosuppression regimen. The moderate reaction was successfully treated with further immunosuppression (prednisone, 0.5 mg/kg). Currently, the patient is asymptomatic, off leprosy medication, with routine liver transplant follow-up. The dilemmas in diagnosis and management of such a case are discussed and the literature on leprosy in transplant recipients is reviewed.
- Corticosteroid use in urticaria multiforme cases Response(2017) SAMORANO, Luciana P.; FERNANDEZ, Vanessa V.; VALENTE, Neusa Y. S.; ARNONE, Marcelo; NICO, Marcello M. S.; RIVITTI-MACHADO, Maria C. M.; OLIVEIRA, Zilda N. P.; CRIADO, Paulo R.
- 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.
- Clinicopathologic correlation of 282 leukocytoclastic vasculitis cases in a tertiary hospital: a focus on direct immunofluorescence findings at the blood vessel wall(2017) TAKATU, Caroline Maris; HERINGER, Antonio Pedro Ribeiro; AOKI, Valeria; VALENTE, Neusa Yuriko Sakai; SANCHEZ, Paula Cristina de Faria; CARVALHO, Jozelio Freire de; CRIADO, Paulo RicardoThis is the largest direct immunofluorescence (DIF) analysis of patients with histology-proven cutaneous leukocytoclastic vasculitis (LCV). To establish the correlation of deposition of immune complexes at the blood vessel walls with underlying causes and prognosis of LCV, we performed a retrospective study from January 2007 to December 2014. The patients are followed at the Department of Dermatology, Hospital Das Clinicas da Faculdade de Medicina da Universidade de So Paulo, a tertiary hospital at So Paulo, Brazil. We reviewed the data of 282 biopsy-proven LCV cases with DIF performed. For the statistical analysis, we included only patients with positive DIF exclusively in vessel walls (235/282 patients). We planned to find a correlation between the DIF profiles of LCV patients and the epidemiology data, underlying causes and prognosis. Ages ranged from five to 87 years old (yo), median age of 45 and 191/282 (67.73 %) were female individuals. DIF analysis showed positivity in 70.21 % of the samples, and C3 was the most frequent immunoreactant. Immunoglobulin A (IgA) deposition at the blood vessel wall was related to age and absence of autoimmune/inflammatory diseases. Immunoglobulin M (IgM) deposition at the blood vessel wall was related to females, autoimmune/inflammatory disorders, C3 and C4 consumption and antinuclear antibody and anti-SSA/anti-SSB positivity. Immunoglobulin G (IgG) deposition at the blood vessel wall was associated with age and positive ANCA; finally, C3 deposition at the blood vessel wall was associated with hematuria and renal involvement. Systemic involvement was present in 12.5 % cases of LCV patients. C3 deposits, the most frequent finding of this study, were related to renal involvement; IgA deposits to absence of autoimmune or inflammatory diseases; IgM deposition to the presence of autoimmune or inflammatory diseases and IgG deposits were associated with positive ANCA. DIF seems to be an important method to establish the prognosis and underlying etiology of LCV. Characterization of the immune complex at the blood vessel wall by DIF is relevant to determine underlying conditions related to LCV.
- Urticaria multiforme: Two cases with histopathological findings(2017) SAMORANO, Luciana P.; FERNANDEZ, Vanessa V.; VALENTE, Neusa Y. S.; ARNONE, Marcelo; NICO, Marcello M. S.; RIVITTI-MACHADO, Maria C. M.; OLIVEIRA, Zilda N. P.; CRIADO, Paulo R.
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.- Recurrent and disseminated pityriasis versicolor: A novel clinical form consequent to Malassezia-host interaction?(2017) ROMERO-SANDOVAL, Karina; COSTA, Anderson Alves; SOUSA, Maria Gloria Teixeira; FURUCHO, Celia Regina; VALENTE, Neusa; CRIADO, Paulo R.; AOKI, Valeria; BENARD, GilPityriasis versicolor is a superficial fungal infection caused by Malassezia spp. The aim of this study is to propose the definition of a new clinical entity: the recurrent and disseminated pityriasis versicolor (RDPV). All patients with RDPV were enrolled over an eight-month period. Clinical and epidemiological data were obtained, Malassezia (M.) species were isolated in cultures and identified by phenotypic and molecular characterization, skin biopsies were taken from active lesions, serum levels of immunoglobulin E were obtained and therapeutic schemes were evaluated. A total of 16 patients were included (11 male, 5 female). The most frequently isolated species were M. japonica (n = 3) and M. furfur (n = 3). This is the first study that isolates M. japonica in patients with pityriasis versicolor; interestingly, those were recalcitrant patients. Seven patients (43.8%) had no cure with any of the proposed treatments; among those, 5 (71.4%) had increased serum IgE levels. The most effective treatment was itraconazole 200 mg daily for 28 days. The RDPV has very different features from the classic form, including a poor response to treatment, and the isolation of different Malassezia species; therefore, we propose a hypothesis for the definition of a new clinical condition (RDPV), which could be a result of the interaction Malassezia-host.