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
12 resultados
Resultados de Busca
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- Generalized pustular psoriasis (von Zumbusch)(2022) ROMITI, Ricardo; HIRAYAMA, Andre Luis da Silva; ARNONE, Marcelo; MAGALHAES, Renata FerreiraGeneralized pustular psoriasis (von Zumbusch) is a rare and acute eruption characterized by multiple sterile pustules over an erythematous and edematous background, eventually associated with psoriasis vulgaris. Classically, it manifests as a potentially severe systemic picture and demands prompt diagnosis and intervention. The duration of each flare-up and intervals between the pustular episodes is extremely variable. Recently, genetic abnormalities have been identified mainly in the familial and early variants of this disease. The therapeutic arsenal is limited; however, new drugs being evaluated aim to control both pustular flare-ups and disease recurrences. (C) 2021 Sociedade Brasileira de Dermatologia.
- Infliximab-induced psoriasis during therapy for Crohn's disease(2012) STEINWURZ, Flavio; DENADAI, Rafael; SAAD-HOSSNE, Rogerio; QUEIROZ, Maria Luiza; TEIXEIRA, Fabio Vieira; ROMITI, RicardoAlthough therapy with tumor necrosis factor-alpha inhibitors (anti-TNF) provides beneficial effects in different immune inflammatory disorders, paradoxical cases of anti-THE-induced psoriasis have increasingly been reported, mostly in the setting of rheumatologic diseases. To date, less than 50 cases of infliximab-induced psoriasis in inflammatory bowel disease patients have been described. The present report was aimed at describing two new cases of infliximab-induced psoriasis during therapy for Crohn's disease and at carrying out a review on this intriguing phenomenon.
- Induction or exacerbation of psoriatic lesions during anti-TNF-alpha therapy for inflammatory bowel disease: A systematic literature review based on 222 cases(2013) DENADAI, Rafael; TEIXEIRA, Fabio Vieira; STEINWURZ, Flavio; ROMITI, Ricardo; SAAD-HOSSNE, RogerioBackground: Paradoxical cases of psoriatic lesions induced or exacerbated by anti-tumor necrosis factor (TNF)-alpha therapy have been reported more frequently in recent years, but data related to inflammatory bowel disease (IBD) are rare. A systematic literature review was performed to provide information about this adverse effect in patients with IBD who receive anti-TNF therapy. Methods: Published studies were identified by a search of Medline, Embase, Cochrane, SciELO, and LILACS databases. Results: A total of 47 studies (222 patients) fulfilled the inclusion criteria and were selected for analysis. Clinical and therapeutic aspects varied considerably among these reports. Of the 222 patients, 78.38% were diagnosed with Crohn's disease, and 48.20% were female. The mean patient age was 26.50 years, and 70.72% of patients had no history of psoriasis. Patients developed psoriasiform lesions (55.86%) more often than other types of psoriatic lesions, and infliximab was the anti-TNF-alpha therapy that caused the cutaneous reaction in most patients (69.37%). Complete remission of cutaneous lesions was observed in 63.96% of the cases. Conclusions: We found that psoriatic lesions occurred predominantly in adult patients with Crohn's disease who received infliximab and had no previous history of psoriasis. Most patients can be managed conservatively without discontinuing anti-INF-alpha therapy.
- 3.41 - Skin Barrier, Microbiome and Psoriasis(2022) HIRAYAMA, A. L. S. da; FONSECA, D. C.; ROMITI, R.Psoriasis is an inflammatory skin disorder of multifactorial etiology related to dysregulation of innate and adaptive immune responses, genetic inheritance and environmental factors. Skin and gut share features and functions. Each one has a singular ecosystem that interacts with epithelial and immune responses. The association of psoriasis with inflammatory bowel disease is well-documented, as well as immune and correlated inflammatory pathways. Recent studies have shown differences in the microbiome of psoriasis suggesting that the influence of gut and skin microbiome can possibly be related with the pathophysiology, disease's course and even its prognosis and treatment response. © 2022 Elsevier Inc. All rights reserved.
- Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis: Subgroup analysis of Latin American patients in the phase 3 randomized UNCOVER-3 study(2017) VALENZUELA, F.; FERNANDEZ, C. de la Cruz; GALIMBERTI, R. L.; GURBUZ, S.; MCKEAN-MATTHEWS, M.; GONCALVES, L.; ROMITI, R.Background and objectives: Ixekizumab demonstrated greater efficacy than placebo and etanercept in UNCOVER-3. Subgroup analysis of Latin American patients was performed. We report 12-week and 60-week data. Patients and methods: Analysis included 102 Latin American patients randomized to receive placebo (n = 14), etanercept 50 mg twice weekly (n = 30), or ixekizumab 160-mg starting dose followed by 80 mg every 2 weeks (Q2W; n = 29) or every 4 weeks (Q4W; n = 29). At week 12, patients maintaining efficacy response and adequate overall safety were assigned, at the discretion of the investigator, to long-term extension with ixekizumab Q4W. Results: At week 12, Psoriasis Area and Severity Index (PASI) 100 scores were 0%, 20.0% (p = 0.075 vs placebo), 62.1% (p < 0.001 vs placebo; p = 0.001 vs etanercept), and 48.3% (p = 0.002 vs placebo; p = 0.023 vs etanercept) for placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively. Among patients who continued therapy up to week 60 (n = 97), PASI 100 scores were 71.4%, 60.0%, 77.8%, and 57.7% for patients who received induction placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively (non-responder imputation). By week 60, >= 1 serious adverse event was experienced by 7.1% (n = 1/14), 3.3% (n = 1/30), 14.8% (n = 4/27), and 0% (n = 0/26) of patients who received induction placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively. There were no cases of active tuberculosis with ixekizumab treatment through 60 weeks. Conclusions: In Latin American patients, both ixekizumab dosing regimens demonstrated greater efficacy than etanercept for treating psoriasis over 12 weeks. The safety profile ofixekizumab through 60 weeks was well tolerated and consistent with the overall profile.
- Translation and validation of the Simplified Psoriasis Index (SPI) into Brazilian Portuguese(2018) MORAIS, Marina Resener de; MARTINS, Gladys Aires; ROMITI, Ricardo; TONOLI, Renata Elise; CARVALHO, Andre Vicente EstevesBACKGROUND: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. OBJECTIVES: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. METHODS: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. RESULTS: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitdrio de Brasilia. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). STUDY LIMITATIONS: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. CONCLUSIONS: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.
- 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.
- Psoriatic scarring alopecia(2013) ALMEIDA, Maiana Carneiro; ROMITI, Ricardo; DOCHE, Isabella; VALENTE, Neusa Yuriko Sakai; DONATI, AlinePsoriasis is a relatively frequent inflammatory dermatosis. Scarring alopecia due to scalp psoriasis was first reported in 1972, but few reports have been written since then, showing that this is a very rare complication of a common disorder. We report a young Brazilian woman with longstanding scalp psoriasis, which progressed to scaring alopecia.
- Systemic amyloidosis manifestation in a patient with psoriatic arthritis(2021) SOUZA, Bruno de Castro e; GAVIOLI, Camila Fatima Biancardi; OLIVEIRA, Walmar Roncalli Pereira de; ROMITI, RicardoSystemic amyloidosis secondary to psoriatic arthritis is rare, and published data are based mainly on case reports and are associated with increased mortality. This is the report of a patient with long-term psoriatic arthritis and chronic sialadenitis, who showed an inadequate response to therapy. The diagnosis of secondary amyloidosis was attained through biopsies of genital skin lesions. Although very rare, it is important that dermatologists and general practitioners consider the possibility of amyloidosis in patients with chronic inflammatory diseases, since an early intervention can be implemented, and thus, the prognosis of this condition can be improved. (c) 2021 Sociedade Brasileira de Dermatologia.
- 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.