WALTER BELDA JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Dermatologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Botryomycosis in patient with pituitary microadenome: A case report(2020) BELDA JR., Walter; CRIADO, Paulo R.; PASSERO, Luiz Felipe D.
article 8 Citação(ões) na Scopus Dermatitis herpetiformis Relevance of the physical examination to diagnosis suspicion(2012) CRIADO, Paulo Ricardo; CRIADO, Roberta Fachini Jardim; AOKI, Valeria; BELDA JR., Walter; HALPERN, Ilana; LANDMAN, Gilles; VASCONCELLOS, Cidia- Successful treatment of chromoblastomycosis caused by Fonsecaea pedrosoi using imiquimod(2020) BELDA JR., Walter; CRIADO, Paulo Ricardo; PASSERO, Luiz Felipe DominguesChromoblastomycosis (CBM) is a fungal infection caused by fungi belonging to the order Chaetothyriales, and caused mainly by Fonsecaea pedrosoi. The classic treatment, based on itraconazole and/or terbinafine as well as physical approaches, is considered complex and ineffective due to the high rate of relapses. Thus, new strategies are needed to manage CBM; in this regard, the present work reports the evolution of lesions in patients successfully treated with imiquimod. Of note, classic treatment was not effective in healing the lesions of two of them, but single topical treatment with imiquimod healed the lesions.
- Extensive long-standing chromomycosis due to Fonsecaea pedrosoi: Three cases with relevant improvement under voriconazole therapy(2011) CRIADO, Paulo Ricardo; CARETA, Mariana Figueiroa; VALENTE, Neusa Y. S.; MARTINS, Jose Eduardo Costa; RIVITTI, Evandro A.; SPINA, Ricardo; BELDA JR., WalterObjective: To evaluate voriconazole in the treatment of extensive cases of chromomycosis. Chromomycosis is a chronic infection, which is extremely difficult to eradicate, and is caused by dematiaceous (dark-colored) fungi which affect the skin and subcutaneous tissues, with Fonsecaea pedrosoi being the major etiologic agent. Drugs such as itraconazole, terbinafine, posaconazole and amphotericin B have been employed with variable results. Methods: We treated three Caucasian male patients (ages 44, 57 and 77 years), two were farmers and one a trash collector, with long-standing (20, 10 and 21 years of disease, respectively) and extensive chromomycosis (one lower limb affected, at least) due to Fonsecaea pedrosoi. All patients had received previous therapy with the formerly indicated drugs itraconazole and terbinafine for several months either without or with incomplete response. After that, we started treatment with voriconazole per os 200 mg twice a day. Results: The patients were treated with voriconazole for 12 months until there was clinical and mycological improvement. Clinical response was evident after 30-50 days. One patient developed visual abnormalities and tremors, and the voriconazole was reduced to 200 mg/day without impairment of the clinical and mycological response. The same patient presented photosensitive dermatitis after 12 months of therapy and the voriconazole was stopped. All patients showed elevations of serum gamma-glutamyl transpeptidase (GGT) during the treatment without clinical relevance. Moreover, our three patients obtained partial response with this therapy. Conclusions: This is the first report with a case series of chromomycosis treated with voriconazole. Despite its high cost, voriconazole is a safe and possibly promising drug for use on extensive chromomycosis refractory to conventional treatment.
- Primary Cutaneous Cryptococcosis Caused by Cryptococcus gatti in an Elderly Patient(2022) BELDA JR., Walter; CASOLATO, Ana T. S.; LUPPI, Juliana B.; PASSERO, Luiz Felipe D.; CRIADO, Paulo R.According to the spread of Cryptococcus sp., fungal infections can be classified as primary or secondary. In primary cutaneous cryptococcosis, the fungi are restricted to the skin of the patients, without systemic involvement. The incidence of primary cutaneous cryptococcosis is high in patients with immunosuppression, and this type of infection is rarely observed in patients who are immunocompetent. In the present case report, a patient who is immunocompetent and has systemic comorbidity reported that, after skin trauma, ulcerovegetative lesions appeared in the right upper arm; the etiologic agent was identified as Cryptococcus gatti, serotype B. The cutaneous lesions healed completely after 5 months of fluconazole treatment.
- Chromoblastomycosis evolving to sarcomatoid squamous cell carcinoma: A case report(2021) BELDA JR., Walter; CRIADO, Paulo Ricardo; CASTELETI, Paula; PASSERO, Luiz Felipe DominguesChromoblastomycosis (CMB) is a cutaneous fungal infection caused by dematiaceous fungi. According to the World Health Organization CMB has been elected as a tropical disease, and it is prevalent in tropical and subtropical regions. The lower extremities are the most affected areas, and the lesions progress with erythema, papules, nodules, verrucose plates and/or ulcerations. So far, few works have demonstrated neoplastic transformation in chronic CMB lesions, and it may be a consequence of prolonged inflammatory response. In the present case report, we described a neoplastic transformation from CMB lesion of a 55-year-old man, presenting lesions only in the left leg for 35 years. After treatment, a verrucous white plate with thick and irregular borders emerged in the ankle, which was identified as a sarcomatoid squamous cell carcinoma. The present case report highlights the importance of an early diagnosis and treatment.
- 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.
- Managing chromoblastomycosis with acitretin plus imiquimod: A case report on the improvement of cutaneous lesions and reduction of the treatment time(2021) BELDA JR., Walter; CASOLATO, Ana Thereza Stradioto; LUPPI, Juliana Bronzato; PASSERO, Luiz Felipe DominguesChromoblastomycosis (CBM) is an infectious disease caused by fungi that is prevalent in tropical and subtropical countries. Besides few therapeutic options, the classical treatment of CBM needs to be administrated for a long period of time, and unfortunately some patients do not show improvement of the lesions. Thus, it becomes urgent to develop new strategies for the treatment of CBM. This work reports a successful treatment, performed with the combination of oral acitretin (50 mg/kg, once a day) plus topical imiquimod (50 mg/g, five times per week) for 5 months in a patient with CBM. A significant improvement of the lesions was observed in the 1st month, and in the 5th a complete regression of lesions was recorded. Changes in the biochemical parameters were not observed. These data suggest that the combination of acitretin and imiquimod may be effective at treating CBM.
- Immunopathological characterization of human cutaneous leishmaniasis lesions caused by Leishmania (Viannia) spp. in Amazonian Brazil(2017) GOMES, Claudia Maria Castro; SOUSA, Maria Gloria Teixeira; MENEZES, Joyce Prieto Bezerra; BATISTA, Marliane Campos; LIMA, Ana Carolina Stocco; BELDA JR., Walter; BRADSHAW, Daniel; GAMA, Monica Elinor Alves; LAURENTI, Marcia Dalastra; SILVEIRA, Fernando Tobias; CORBETT, Carlos Eduardo PereiraAmerican cutaneous leishmaniasis (ACL) is a chronic infectious disease caused by different protozoan species of Leishmania, and it is endemic in both tropical and subtropical countries. Using immunohistochemistry, we investigate the density of CD68(+), lysozyme(+), CD1a(+), factor XIIIa(+), CD4(+), CD8(+), CD56(+), interferon (IFN)-gamma(+), and inducible NO synthase (iNOS(+)) cells. These cells were analyzed from 22 biopsy samples obtained from the lesions of ACL patients, whose infection was caused by Leishmania (Viannia) spp. Histopathological analysis showed dense mononuclear inflammatory infiltration in the dermis, which was composed of lymphocytes, macrophages, plasma cells, and discrete tissue parasitism. Granulomatous reactions were also present in the majority of cases. The density of the activated macrophages was higher than that of inactivated macrophages in the lesions. The density of Langerhans cells (CD1a(+)) was lower than that of dermal dendrocytes (factor XIIIa(+)). The density of CD8(+) T lymphocytes was higher than that of CD4(+) T lymphocytes. The cellular density of these immunological markers in relation to the species of Leishmania demonstrated that L. (Viannia) sp. lesions had higher IFN-gamma expression than that Leishmania (Viania) braziliensis lesions. The evaluation of these markers, according to disease progression, did not reveal any significant differences. L. (Viannia) sp. infection leads to a favorable immune response in the host, as predominantly represented by lysozyme(+), factor XIIIa(+), CD8(+) T cells, and the expression of (IFN)-gamma(+) at the lesion site.