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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- Diagnostic and therapeutic guidelines for plaque psoriasis - Brazilian Society of Dermatology(2019) ARNONE, Marcelo; TAKAHASHI, Maria Denise Fonseca; CARVALHO, Andre Vicente Esteves de; BERNARDO, Wanderley Marques; BRESSAN, Aline Lopes; RAMOS, Andrea Machado Coelho; TERENA, Aripuana Coberio; SOUZA, Cacilda da Silva; NUNES, Daniel Holthausen; BORTOLETTO, Maria Cecilia de Carvalho; OLIVEIRA, Maria de Fatima Santos Paim de; NEFFA, Jane Marcy; FIERI, Luciana Cristina; AZULAY-ABULAFIA, Luna; FELIX, Paulo Antonio Oldani; MAGALHAES, Renata Ferreira; ROMITIL, Ricardo; JAIME, Tatiana JerezPsoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian population. The most common clinical manifestations are erythematous, scaling lesions that affect both genders and can occur on any anatomical site, preferentially involving the knees, elbows, scalp and genitals. Besides the impact on the quality of life, the systemic nature of the disease makes psoriasis an independent risk factor for cardiovascular disease, especially in young patients with severe disease. By an initiative of the Brazilian Society of Dermatology, dermatologists with renowned clinical experience in the management of psoriasis were invited to form a work group that, in a partnership with the Brazilian Medical Association, dedicated themselves to create the Plaque Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the diagnosis (evaluation of severity and comorbidities) and treatment of plaque psoriasis were defined. The issues generated a search strategy in the Medline-PubMed database up to July 2018. Subsequently, the answers to the questions of the recommendations were devised, and each reference selected presented the respective level of recommendation and strength of scientific evidence. The final recommendations for making up the final text were worded by the coordinators.
- Panniculitis in childhood-onset systemic lupus erythematosus: a multicentric cohort study(2019) VERDIER, Monica; ANUARDO, Pedro; GORMEZANO, Natali Weniger Spelling; ROMITI, Ricardo; CAMPOS, Lucia Maria Arruda; AIKAWA, Nadia Emi; PEREIRA, Rosa Maria Rodrigues; TERRERI, Maria Teresa; MAGALHAES, Claudia Saad; FERREIRA, Juliana C. O. A.; SILVA, Marco Felipe Castro; FERRIANI, Mariana; SAKAMOTO, Ana Paula; FERRIANI, Virginia Paes Leme; CENTEVILLE, Maraisa; SATO, Juliana; SANTOS, Maria Carolina; BONFA, Eloisa; SILVA, Clovis ArturObjective: To evaluate prevalence, clinical manifestations, laboratory abnormalities, treatment and outcome in a multicenter cohort of childhood-onset systemic lupus erythematosus (cSLE) patients with and without panniculitis. Methods: Panniculitis was diagnosed due to painful subcutaneous nodules and/or plaques in deep dermis/subcutaneous tissues and lobular/mixed panniculitis with lymphocytic lobular inflammatory infiltrate in skin biopsy. Statistical analysis was performed using Bonferroni correction(p <0.004). Results: Panniculitis was observed in 6/847(0.7%) cSLE. Painful subcutaneous erythematosus and indurated nodules were observed in 6/6 panniculitis patients and painful subcutaneous plaques in 4/6. Generalized distribution was evidenced in 3/ 6 and localized in upper limbs in 2/6 and face in 1/6. Cutaneous hyperpigmentation and/or cutaneous atrophy occurred in 5/6. Histopathology features showed lobular panniculitis without vasculitis in 5/6(one of them had concomitant obliterative vasculopathy due to antiphospholipid syndrome) and panniculitis with vasculitis in 1/6. Comparison between cSLE with panniculitis and 60 cSLE without panniculitis with same disease duration [2.75(0-11.4) vs. 2.83(0-11.8) years,p = 0297], showed higher frequencies of constitutional involvement (67% vs. 1 0%,p = 0.003) and leukopenia (67% vs. 7%p = 0.002). Cutaneous atrophy and hyperpigmentation occurred in 83% of patients. Conclusions: Panniculitis is a rare skin manifestation of cSLE occurring in the first three years of disease with considerable sequelae. The majority of patients have concomitant mild lupus manifestations.
- Axillary involvement in frontal fibrosing alopecia: clinical, dermoscopy and histological features(2019) MUNCK, A.; VALENTE, N.; ROMITI, R.
bookPart Esclerose(2019) ROSAN, Isadora; MIOTTO, Isadora; ROMITI, Ricardo- Metabolic syndrome and psoriatic arthritis among patients with psoriasis vulgaris: Quality of life and prevalence(2019) SOUZA, Cacilda S.; CASTRO, Caio C. S. de; CARNEIRO, Francisca R. O.; PINTO, Jane M. N.; FABRICIO, Lincoln H. Z.; AZULAY-ABULAFIA, Luna; ROMITI, Ricardo; CESTARI, Tania F.; SUZUKI, Claudia E.; BIEGUN, Priscila M.; GUEDES, Luciana S.; OYAFUSO, Luiza K. M.Interest has increased in comorbidities associated with psoriasis and their effects on health-related quality of life (HRQoL). This study aimed to evaluate the prevalence of metabolic syndrome (MetS) and psoriatic arthritis (PsA) and to investigate HRQoL and the prevalence of hypertension, type 2 diabetes mellitus (T2DM), obesity and dyslipidemia. In a cross-sectional design, patients diagnosed with plaque psoriasis answered an interview and standardized questionnaires (Dermatology Life Quality Index questionnaire [DLQI], 36-Item Short Form Health Survey [SF-36] and EuroQol Five-Dimension Questionnaire Three-Level version [EQ-5D-3L]). Physical examination and several tests to assess desired outcomes were performed by a dermatologist and a rheumatologist during three visits. The prevalence of MetS and PsA was 50.0% and 41.8%, respectively. Dyslipidemia was the most prevalent (74.5%) secondary comorbidity, followed by hypertension (61.8%), obesity (52.5%) and T2DM (30.9%). The mean (standard deviation) DLQI score was 6.5 (6.9), and mean physical and mental SF-36 measures were 45.2 (10.4) and 45.5 (12.3), respectively, and for EQ-5D-3L, mean utility index and EQ-VAS scores were 0.68 (0.27) and 72.7 (19.7), respectively. PsA and MetS are important comorbidities; a reduced HRQoL is noted among plaque psoriasis patients with these comorbidities, emphasizing the relevance of diagnosis and treatment beyond the care of skin lesions.
- Nonfamilial Multiple Trichoepithelioma(2019) MIOTTO, Isadora Zago; ROMITI, RicardoThis case report describes a woman in her 30s who presented with multiple papules and nodules on the face that first appeared in childhood and were progressive into early adult age.
- 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
- Humanistic and Economic Impact of Moderate to Severe Plaque Psoriasis in Brazil(2019) LOPES, Nilceia; DIAS, Leticia L. S.; AZULAY-ABULAFIA, Luna; OYAFUSO, Luiza K. M.; SUAREZ, Maria Victoria; FABRICIO, Lincoln; KOBATA, Clarice Marie; CESTARI, Tania; GONTIJO, Bernardo; SABBAG, Cid Y.; ANTONIO, Joao R.; ROMITI, Ricardo; PERTEL, Patricia C.Introduction Psoriasis is an immune-mediated, chronic, inflammatory disease, which has a substantial humanistic and economic burden. This study aimed to assess the impact of this disease on health-related quality of life (HRQoL), work productivity, and direct and indirect costs from a societal perspective among Brazilian patients. Methods This is a cross-sectional, observational, multicenter study, enrolling patients with moderate to severe plaque psoriasis according to physician evaluation. Data collection was performed from December 2015 to November 2016 through face-to-face interviews using a structured questionnaire and five standardized patient-reported outcomes instruments. Direct costs were estimated by multiplying the amount of resources used (12-month recall period) by the corresponding unit cost. Indirect costs were grouped in two time horizons: annual costs (income reduction and absenteeism) and lifetime costs (demission and early retirement). Results A total of 188 patients with moderate to severe plaque psoriasis were included, with mean age of 48.0 (SD 13.1). ""Anxiety and depression"" and ""pain and discomfort"" were the most impaired dimensions, according to the EuroQol Five-Dimension-Three-Level (EQ-5D-3L). The highest effect was found for ""symptoms and feelings"" [mean (SD) 2.4 (1.7)] Dermatology Life Quality Index (DLQI) subscale. Psoriatic arthritis (PsA) presence and biologic-naive status were associated with worse HRQoL. Presenteeism was more frequent than absenteeism, according to the Work Productivity and Activity Impairment questionnaire-General Health (WPAI-GH) [17.4% vs. 6.3%], while physical demands and time management were the most affected Work Limitations Questionnaire (WLQ) subscales [means (SD) 23.5 (28.5) and 17.7 (24.9), respectively]. The estimated annual cost per patient was USD 4034. Direct medical costs accounted for 87.7% of this estimate, direct non-medical costs for 2.4%, and indirect costs for 9.9%. Conclusions Results evidenced that moderate to severe plaque psoriasis imposes substantial costs to society. Our data showed that this disease negatively affects both work productivity and HRQoL of Brazilian patients. Subgroups with PsA and biologic-naive patients presented lower HRQoL, showing the impact of this comorbidity and the relevance of biologics in psoriasis treatment. Funding Novartis Biociencias S.A.
- Female Progressive Scalp Hair Loss Associated with Ovarian Thecoma(2019) MUNCK, Andreia; LOPES, Andressa Sato de Aquino; ANZAI, Alessandra; FECHINE, Carolina Oliveira Costa; VALENTE, Neusa Yuriko Sakai; ROMITI, Ricardo
- Prevalence and outcome of latent tuberculosis in patients receiving ixekizumab: integrated safety analysis from 11 clinical trials of patients with plaque psoriasis(2019) ROMITI, R.; VALENZUELA, F.; CHOUELA, E. N.; XU, W.; PANGALLO, B.; MORIARTY, S. R.; GURBUZ, S.; RIEDL, E.