LIVIA DELGADO
Projetos de Pesquisa
Unidades Organizacionais
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Exfoliative erythroderma as a clinical manifestation of autoimmune bullous diseases(2016) MIYAMOTO, Denise; BATISTA, Daniel I. S.; SANTI, Claudia G.; MARUTA, Celina W.; DELGADO, Livia; AOKI, Valeria
- Profile of Trypanosoma cruzi Reactivity in a Population at High Risk for Endemic Pemphigus Foliaceus (Fogo Selvagem)(2012) SOUSA JR., Joaquim X.; DIAZ, Luis A.; EATON, Donald P.; HANS-FILHO, Guenter; FREITAS, Elder Lanzani de; DELGADO, Livia; ICHIMURA, Ligia Maria F.; CRISTALDI, Flavia; ORLANDI, Renata; KESPER JR., Norival; UMEZAWA, Eufrosina S.; RIVITTI, Evandro A.; AOKI, ValeriaFogo Selvagem (FS) is an autoimmune bullous disease with pathogenic IgG autoantibodies recognizing desmoglein 1 (Dsg1), a desmosomal glycoprotein. In certain settlements of Brazil, a high prevalence of FS (3%) is reported, suggesting environmental factors as triggers of the autoimmune response. Healthy individuals from endemic areas recognize nonpathogenic epitopes of Dsg1, and exposure to hematophagous insects is a risk factor for FS. Fogo selvagem and Chagas disease share some geographic sites, and anti-Dsg1 has been detected in Chagas patients. Indeterminate Chagas disease was identified in a Brazilian Amerindian population of high risk for FS. In counterpart, none of the FS patients living in the same geographic region showed reactivity against Trypanosoma cruzi. The profile of anti-Dsg1 antibodies showed positive results in 15 of 40 FS sera and in 33 of 150 sera from healthy individuals from endemic FS sites, and no cross-reactivity between Chagas disease and FS was observed.
- Report of Allergic Reaction After Application of Botulinum Toxin(2015) CARETA, Mariana Figueiroa; DELGADO, Livia; PATRIOTA, RegiaBotulinum toxin is a widely used treatment with satisfactory results, and it is relatively safe in the doses used for cosmetic procedures. The authors report a case of allergic reaction to Chinese botulinum toxin serotype A (CBTX-A). Although this is a rare adverse event, it is nonetheless clinically relevant to healthcare professionals. A 44-year-old woman presented to the authors' hospital complaining of dynamic wrinkles. CBTX-A was used to treat her. Minutes after application, she developed urticarial plaques proximal to the injection site. The patient had an allergic reaction, as documented by a positive skin test, which was controlled by the administration of antihistamines and systemic corticosteroids. This report is intended to guide healthcare professionals faced with this type of adverse event regarding how to proceed without hindering the delivery and effectiveness of the treatment. When performed by a qualified health professional, this treatment brings excellent results in the vast majority of cases.
- Dermoscopy revealing a case of Tinea Nigra(2013) CRIADO, Paulo Ricardo; DELGADO, Livia; PEREIRA, Gustavo AlonsoDermoscopy has being used over the past twenty years as a noninvasive aid in the diagnosis of innumerable skin conditions, including infectious diseases and infestations (Entodermoscopy). Tinea nigra is a superficial phaeohyfomycosis that affects mainly the glabrous skin of palms and soles. We describe a 14 year-old girl with a three-month history of an enlarging brown patch of her hand diagnosed as Tinea Nigra following clinical and dermoscopy examination. These images emphasize the importance of dermoscopy as a diagnostic tool in the daily routine of dermatologists.
conferenceObject Epitope spreading in pemphigus patients from Sao Paulo, Brazil: A 10-year follow-up(2013) DELGADO, Livia; MARUTA, Celina W.; SANTI, Claudia G.; MYAMOTO, Denise; AOKI, ValeriaBackground: Pemphigus is a rare autoimmune blistering dermatosis. The shift from a disease to another is known as ‘‘epitope spreading’’ (ES). A primary inflammatory/autoimmune process releases ‘‘hidden’’ epitopes, and evokes a secondary reaction to antigens, distinct from and none cross-reactive with the target epitope. ES may be intra- or intermolecular. Objectives: The aim of the present study is to analyze the occurrence of ES within a 10-year interval in pemphigus patients followed-up at the Department of Dermatology, University of São Paulo, Brazil. Methods: Thestudy wascarried out in 351 pemphigus patients from January 2002 to January 2012. A careful search for clinical and laboratory changes suggestive of transition to a secondary bullous disease was performed, including clinical evaluation by at least 2 dermatologists. Laboratory profile (histopathology, direct-DIF and indirect-IIF immunofluorescence, and ELISA) was requested when suspicious skin lesions were detected. Results: Eight out of 351 pemphigus patients (153 pemphigus foliaceus-PF and 198 pemphigus vulgaris-PV) presented clinical transition: 7 from PV to PF (group 1) and 1 from PF to epidermolysis bullosa acquisita (EBA) (group 2). In group 1, median age at PVonset was 54 years and median interval of the disease shift was 3 years. Of the 7 patients with clinical PF, 4 showed change of pattern from suprabasilar cleavage to subcorneal acantholysis, 2 had cleavage within the middle epidermal layer, and 1 sustained the suprabasilar acantholysis. All patients showed intercellular IgG and C3 deposits during PVand PF diagnosis by DIF. IIF titers varied from 1:160 to 1:5120, and were positive during ES. ELISA index for Dsg1 varied from 1 to 319, and for Dsg3 from 0 to 290. Dsg1/Dsg3 indexes corresponded to the clinical PV-PF changes. In group 2, one patient switched from PF to EBA; onset of PF occurred at the age of 7, and ES to EBA 25 years later. Laboratory evaluation showed subepidermal cleavage with neutrophils, IgG intercellular staining in the epidermis and IgM, IgA, IgG and C3 deposits at BMZ by DIF, IgG deposits by indirect salt-split, recognition of collagen VII by immunoblotting, and positive ELISA for Dsg1. Conclusions: Intermolecular ES occurred in 2.2% of pemphigus patients. Futures studies will be necessary to elucidate the pathogenesis of this event and its significance in pemphigus progression.- Immunofluorescence testing in the diagnosis of autoimmune blistering diseases: overview of 10-year experience(2014) ARBACHE, Samia Trigo; DELGADO, Livia; AOKI, Valeria; NOGUEIRA, Tarsila Gasparotto; MIYAMOTO, DeniseBACKGROUND: Immunofluorescence testing is an important tool for diagnosing autoimmune blistering diseases. OBJECTIVE: To characterize the immunofluorescence findings in patients diagnosed with autoimmune blistering skin diseases. METHODS: We retrospectively analyzed immunofluorescence results encompassing a 10-year period. RESULTS: 421 patients were included and divided into 2 groups: group 1-intraepidermal blistering diseases (n=277) and 2-subepidermal blistering diseases (n=144). For group 1, positive DIF findings demonstrated: predominance of IgG intercellular staining (ICS) and C3 for pemphigus foliaceus-PF (94% and 73% respectively), pemphigus vulgaris-PV (91.5%-79.5%) and paraneoplastic pemphigus-PNP (66%-33%); ICS IgA in 100% of IgA pemphigus cases, and IgG deposits in the basement membrane zone (BMZ) along with ICS in one Hailey-Hailey patient. The IIF findings revealed mean titers of 1:2.560 for PV and 1:1.280 for PF. For paraneoplastic pemphigus, IIF was positive in 2 out of 3 cases with rat bladder substrate. In group 2, positive DIF findings included multiple deposits at basement membrane zone for epidermolysis bullosa acquisita-EBA (C3-89%, IgG-79%, IgA-47%, IgM-21%) mucous membrane pemphigoid-MMP (C3, IgG, IgA, IgM-80%) and bullous pemphigoid-BP (C3-91%, IgG-39%, IgA-11%, IgM-6%), and IgA at basement membrane zone for IgA linear disease (99%) and dermatitis herpetiformis-DH (dermal papillae in 84.6%). For lichen planus pemphigoides, there was C3 (100%) and IgG (50%) deposition at basement membrane zone. indirect immunofluorescence positive findings revealed basement membrane zone IgG deposits in 46% of BP patients, 50% for EBA, 15% for IgA linear dermatosis and 50% for LPP. Indirect immunofluorescence positive results were higher for BP and EBA with Salt-Split skin substrate. CONCLUSION: Our results confirmed the importance of immunofluorescence assays in diagnosing autoimmune blistering diseases, and higher sensitivity for indirect immunofluorescence when Salt-split skin technique is performed.