RICARDO ROMITI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
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- 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.
- Genital discoid lupus: a rare manifestation of cutaneous lupus erythematosus(2014) ROMITI, R.; ANZAI, A.; NICO, M. M.Cutaneous lupus erythematosus classically presents as sharply demarcated plaques with pigmentary changes and varying degrees of scarring typically affecting the face and scalp. Genital manifestations of lupus erythematosus have rarely been described in literature. Here we report two cases of discoid lupus erythematosus affecting the genital area. Both patients were equally affected by widespread discoid lesions on the head. Although rare, genital involvement of lupus erythematosus must be considered in the differential diagnosis of genital lesions.
- Tinea capitis(2021) ROMITI, R.; ANZAI, A.
- Lichen Planopilaris with Pustules: A Diagnostic Challenge(2018) MORAIS, Karina L.; MARTINS, Cintia F.; ANZAI, Alessandra; VALENTE, Neusa Y. S.; ROMITI, RicardoIntroduction: Lichen planopilaris (LPP) is a lymphocytic primary cicatricial alopecia presenting with scarring hair loss and variable degrees of perifollicular erythema and scaling. Pustules are infrequent and may mimic folliculitis decalvans (FD) and other forms of neutrophilic alopecia. We present a series of LPP cases with pustules and discuss the importance of differentiating them from primary neutrophilic folliculitis. Materials and Methods: Demographic, clinical, histopathological, and follow-up data of 13 cases of LPP with pustules followed at the Department of Dermatology of the University of Sao Paulo Medical School were described. Results: Seven females and 6 males were included. Onset of signs and symptoms ranged from 23 to 61 years of age. Previous diagnoses were FD in 3 patients, pityriasis amiantacea in 2 cases, and folliculitis keloidalis nuchae in 1 case. Other 7 cases presented typical clinical features of LPP. Discussion: There is limited data concerning LPP with pustules. Our analysis shows that LPP should be considered a differential diagnosis in patients with refractory folliculitis. Cautious examination of the entire scalp with dermoscopy and/or reevaluation after a course of antibiotics can avoid misdiagnosis. Further studies are required to establish the etiology of pustules in the setting of LPP. (c) 2017 S. Karger AG, Basel
- 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.
- 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
- Headband pressure alopecia: clinical, dermoscopy, and histopathology findings in four patients(2018) SANO, Daniela T.; KAKIZAKI, Priscila; ANZAI, Alessandra; DONATI, Aline; VALENTE, Neusa Y. S.; ROMITI, Ricardo
- Trichoscopy findings of frontal fibrosing alopecia on the eyebrows: A study of 151 cases(2021) ANZAI, Alessandra; PIRMEZ, Rodrigo; VINCENZI, Colombina; FABBROCINI, Gabriella; ROMITI, Ricardo; TOSTI, AntonellaBackground: Eyebrow loss (madarosis) is a frequent sign of frontal fibrosing alopecia (FFA), and it can be the first sign of the disease. Objective: To describe trichoscopy findings of FFA on the eyebrows. Methods: The analysis included 151 women with histologically proven diagnosis of FFA and eyebrow loss. Trichoscopy of the eyebrow area was performed with either a FotoFinder videodermatoscope or handheld dermoscope DermLite II pro. Results: The most frequent signs on trichoscopy were yellow dots (92.7%), multiple pinpoint dots (79.5%), short thin hairs/vellus (76.2%), black dots (66.2%), and dystrophic hairs (60.9%). Tapering hairs were found in 21 (13.9%) patients and dystrophic hairs in 92 (60.9%) patients. Limitations: Inner limitations of a case series (there was no comparison with healthy control individuals or patients with other hair disorders) and lack of histologic correlation to the trichoscopy findings. Conclusions: Although FFA is a scarring alopecia, the most common trichoscopy signs found in the eyebrows are usually related to noncicatricial alopecia. Therefore, in most cases, trichoscopy of the eyebrows does not resemble the trichoscopy of FFA on the scalp. Black dots, dystrophic hairs, and broken hairs are frequent signs. Occasionally, tapered hairs can be present on the eyebrows in FFA, leading to misdiagnosis of alopecia areata. ( J Am Acad Dermatol 2021;85:1130-4.)
- 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