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1.
An. bras. dermatol ; 93(6): 829-835, Nov.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-973620

RESUMO

Abstract: Background: Allergic contact dermatitis to ion nickel (Ni+2) is an inflammatory dermatosis, common in industrialized countries. It involves the activation of nickel-specific T-cells, followed by proliferation and induction of a mixed profile of both proinflammatory and regulatory cytokines, suggesting that several T-cell subtypes (helper - Th and cytotoxic - Tc) are involved. A broader understanding of the cytokine profile may lead to new therapeutic approaches. Objectives: This study aimed to analyze the cytokines TNF-α, INF-γ, IL-2, IL-4, IL-10, IL-13, IL-17 and IL-23 using the immunohistochemistry technique in order to try to identify their prevalence in chronic and acute eczema of patients with allergic contact dermatitis to Ni+2. Methods: We performed an immunohistochemical study for eight cytokines in 20 patients with Ni+2 allergic contact dermatitis, biopsied at the site of chronic eczema, triggered by the patient's daily contact with Ni+2, and at the site of acute eczema caused by nickel sulfate, 48 hours after applying the contact test. Results: The stained samples showed positive results for the eight cytokines studied. TNF-α, IFN-γ, IL-4, IL-13 and IL-17 had a higher prevalence in chronic eczema, IL-2 and IL-23 in acute eczema, and IL-10 presented a similar prevalence in both acute and chronic eczema. However, these prevalences were statistically significant only for IL-4 and IL-13. Study Limitations: Small sample size. Conclusions: In chronic and acute eczema, we observed the presence of a mixed cytokine profile of the T cell subtypes (Th/Tc), suggesting that the responses are expressed at the same time.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Citocinas/análise , Interleucinas/análise , Interferon gama/análise , Fator de Necrose Tumoral alfa/análise , Dermatite Alérgica de Contato/imunologia , Níquel/efeitos adversos , Biópsia , Imuno-Histoquímica , Doença Aguda , Doença Crônica , Estudos Prospectivos , Citocinas/imunologia , Interleucinas/imunologia , Interferon gama/imunologia , Fator de Necrose Tumoral alfa/imunologia , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Níquel/imunologia
2.
An Bras Dermatol ; 93(6): 829-835, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30484527

RESUMO

BACKGROUND: Allergic contact dermatitis to ion nickel (Ni+2) is an inflammatory dermatosis, common in industrialized countries. It involves the activation of nickel-specific T-cells, followed by proliferation and induction of a mixed profile of both proinflammatory and regulatory cytokines, suggesting that several T-cell subtypes (helper - Th and cytotoxic - Tc) are involved. A broader understanding of the cytokine profile may lead to new therapeutic approaches. OBJECTIVES: This study aimed to analyze the cytokines TNF-α, INF-γ, IL-2, IL-4, IL-10, IL-13, IL-17 and IL-23 using the immunohistochemistry technique in order to try to identify their prevalence in chronic and acute eczema of patients with allergic contact dermatitis to Ni+2. METHODS: We performed an immunohistochemical study for eight cytokines in 20 patients with Ni+2 allergic contact dermatitis, biopsied at the site of chronic eczema, triggered by the patient's daily contact with Ni+2, and at the site of acute eczema caused by nickel sulfate, 48 hours after applying the contact test. RESULTS: The stained samples showed positive results for the eight cytokines studied. TNF-α, IFN-γ, IL-4, IL-13 and IL-17 had a higher prevalence in chronic eczema, IL-2 and IL-23 in acute eczema, and IL-10 presented a similar prevalence in both acute and chronic eczema. However, these prevalences were statistically significant only for IL-4 and IL-13. STUDY LIMITATIONS: Small sample size. CONCLUSIONS: In chronic and acute eczema, we observed the presence of a mixed cytokine profile of the T cell subtypes (Th/Tc), suggesting that the responses are expressed at the same time.


Assuntos
Citocinas/análise , Dermatite Alérgica de Contato/imunologia , Interferon gama/análise , Interleucinas/análise , Níquel/efeitos adversos , Fator de Necrose Tumoral alfa/análise , Doença Aguda , Adulto , Idoso , Biópsia , Doença Crônica , Citocinas/imunologia , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Feminino , Humanos , Imuno-Histoquímica , Interferon gama/imunologia , Interleucinas/imunologia , Masculino , Pessoa de Meia-Idade , Níquel/imunologia , Estudos Prospectivos , Fator de Necrose Tumoral alfa/imunologia , Adulto Jovem
3.
An Bras Dermatol ; 93(2): 242-250, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29723367

RESUMO

Skin's innate immunity is the initial activator of immune response mechanisms, influencing the development of adaptive immunity. Some contact allergens are detected by Toll-like receptors (TLRs) and inflammasome NLR3. Keratinocytes participate in innate immunity and, in addition to functioning as an anatomical barrier, secrete cytokines, such as TNF, IL-1ß, and IL-18, contributing to the development of Allergic Contact Dermatitis. Dendritic cells recognize and process antigenic peptides into T cells. Neutrophils cause pro-inflammatory reactions, mast cells induce migration/maturation of skin DCs, the natural killer cells have natural cytotoxic capacity, the γδ T cells favor contact with hapten during the sensitization phase, and the innate lymphoid cells act in the early stages by secreting cytokines, as well as act in inflammation and tissue homeostasis. The antigen-specific inflammation is mediated by T cells, and each subtype of T cells (Th1/Tc1, Th2/Tc2, and Th17/Tc17) activates resident skin cells, thus contributing to inflammation. Skin's regulatory T cells have a strong ability to inhibit the proliferation of hapten-specific T cells, acting at the end of the Allergic Contact Dermatitis response and in the control of systemic immune responses. In this review, we report how cutaneous innate immunity is the first line of defense and focus its role in the activation of the adaptive immune response, with effector response induction and its regulation.


Assuntos
Dermatite Alérgica de Contato/imunologia , Imunidade Inata/imunologia , Pele/imunologia , Linfócitos T/imunologia , Citocinas/imunologia , Humanos , Linfócitos T Reguladores/imunologia , Receptores Toll-Like/imunologia
4.
An. bras. dermatol ; 93(2): 242-250, Mar.-Apr. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-887186

RESUMO

Abstract: Skin's innate immunity is the initial activator of immune response mechanisms, influencing the development of adaptive immunity. Some contact allergens are detected by Toll-like receptors (TLRs) and inflammasome NLR3. Keratinocytes participate in innate immunity and, in addition to functioning as an anatomical barrier, secrete cytokines, such as TNF, IL-1β, and IL-18, contributing to the development of Allergic Contact Dermatitis. Dendritic cells recognize and process antigenic peptides into T cells. Neutrophils cause pro-inflammatory reactions, mast cells induce migration/maturation of skin DCs, the natural killer cells have natural cytotoxic capacity, the γδ T cells favor contact with hapten during the sensitization phase, and the innate lymphoid cells act in the early stages by secreting cytokines, as well as act in inflammation and tissue homeostasis. The antigen-specific inflammation is mediated by T cells, and each subtype of T cells (Th1/Tc1, Th2/Tc2, and Th17/Tc17) activates resident skin cells, thus contributing to inflammation. Skin's regulatory T cells have a strong ability to inhibit the proliferation of hapten-specific T cells, acting at the end of the Allergic Contact Dermatitis response and in the control of systemic immune responses. In this review, we report how cutaneous innate immunity is the first line of defense and focus its role in the activation of the adaptive immune response, with effector response induction and its regulation.


Assuntos
Humanos , Pele/imunologia , Linfócitos T/imunologia , Dermatite Alérgica de Contato/imunologia , Imunidade Inata/imunologia , Citocinas/imunologia , Linfócitos T Reguladores/imunologia , Receptores Toll-Like/imunologia
5.
An Bras Dermatol ; 90(1): 74-89, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25672302

RESUMO

Chronic urticaria has been explored in several investigative aspects in the new millennium, either as to its pathogenesis, its stand as an autoimmune or auto-reactive disease, the correlation with HLA-linked genetic factors, especially with class II or its interrelation with the coagulation and fibrinolysis systems. New second-generation antihistamines, which act as good symptomatic drugs, emerged and were commercialized over the last decade. Old and new drugs that may interfere with the pathophysiology of the disease, such as cyclosporine and omalizumab have been developed and used as treatments. The purpose of this article is to describe the current state of knowledge on aspects of chronic urticaria such as, pathophysiology, diagnosis and the current therapeutic approach proposed in the literature.


Assuntos
Urticária/tratamento farmacológico , Urticária/patologia , Corticosteroides/uso terapêutico , Adulto , Antialérgicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Doença Crônica , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Masculino , Testes Cutâneos , Urticária/classificação , Urticária/etiologia
6.
An. bras. dermatol ; 90(1): 74-89, Jan-Feb/2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-735743

RESUMO

Chronic urticaria has been explored in several investigative aspects in the new millennium, either as to its pathogenesis, its stand as an autoimmune or auto-reactive disease, the correlation with HLA-linked genetic factors, especially with class II or its interrelation with the coagulation and fibrinolysis systems. New second-generation antihistamines, which act as good symptomatic drugs, emerged and were commercialized over the last decade. Old and new drugs that may interfere with the pathophysiology of the disease, such as cyclosporine and omalizumab have been developed and used as treatments. The purpose of this article is to describe the current state of knowledge on aspects of chronic urticaria such as, pathophysiology, diagnosis and the current therapeutic approach proposed in the literature.


Assuntos
Adulto , Feminino , Humanos , Masculino , Urticária/tratamento farmacológico , Urticária/patologia , Corticosteroides/uso terapêutico , Antialérgicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Doença Crônica , Antagonistas dos Receptores Histamínicos/uso terapêutico , Testes Cutâneos , Urticária/classificação , Urticária/etiologia
7.
São Paulo; Manole; 4 ed; 2015. 640 p. ilus, tab, graf.
Monografia em Português | Coleciona SUS | ID: biblio-943852
8.
An. bras. dermatol ; 89(6,supl.1): 1-74, Nov-Dec/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-741059

RESUMO

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.


Assuntos
Humanos , Proteção Radiológica/métodos , Queimadura Solar/prevenção & controle , Protetores Solares/administração & dosagem , Dermatopatias/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Neoplasias Cutâneas/epidemiologia , Energia Solar/estatística & dados numéricos , Queimadura Solar/epidemiologia , Protetores Solares/química , Raios Ultravioleta/efeitos adversos , Vitamina D/metabolismo , Brasil/epidemiologia , Vestuário , Exposição Ambiental , Radiação Eletromagnética , Promoção da Saúde/métodos , Conceitos Meteorológicos
9.
An Bras Dermatol ; 89(6 Suppl 1): 1-74, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25761256

RESUMO

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.


Assuntos
Proteção Radiológica/métodos , Queimadura Solar/prevenção & controle , Protetores Solares/administração & dosagem , Brasil/epidemiologia , Vestuário , Radiação Eletromagnética , Exposição Ambiental , Promoção da Saúde/métodos , Humanos , Conceitos Meteorológicos , Dermatopatias/prevenção & controle , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/prevenção & controle , Energia Solar/estatística & dados numéricos , Queimadura Solar/epidemiologia , Protetores Solares/química , Raios Ultravioleta/efeitos adversos , Vitamina D/metabolismo
10.
An Bras Dermatol ; 88(5): 719-25, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24173176

RESUMO

BACKGROUND: Patch testing remains the gold standard method for the identification of the etiologic agent of allergic contact dermatitis. However, it is a subjective, time-consuming exam whose technique demands special care and which presents some contraindications, which hamper its use. In a recent study, we showed that the proliferation assay can suitably replace patch testing for the diagnosis of chromium allergy, which had been previously demonstrated only for nickel allergy. In this study, we try to refine the method by reducing the incubation period of cultures for lymphocyte proliferation assays in response to chromium. OBJECTIVE: Develop an alternative or complementary diagnostic test for chromium allergic contact dermatitis. METHODS: We compared the production of 9 cytokines (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 and RANTES) between 18 chromium-allergic patients and 19 controls. RESULTS: Chromium increased the production of IFN-y, IL-5, IL-2 and IL-13 in allergic patients, but only IL-2 and especially IL-13 helped discriminate allergic patients from controls. The sensitivity, specificity and accuracy found with IL-13 were about 80%. CONCLUSIONS: IL-13 and IL-2 detection may be used to diagnose chromium allergy in 2-day cultures. However, in general, the 6-day cultures seem to be superior for this purpose.


Assuntos
Cromo/toxicidade , Citocinas/sangue , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/métodos , Adulto , Idoso , Células Cultivadas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Fatores de Tempo
11.
An. bras. dermatol ; 88(5): 719-725, out. 2013. graf
Artigo em Inglês | LILACS | ID: lil-689737

RESUMO

BACKGROUND: Patch testing remains the gold standard method for the identification of the etiologic agent of allergic contact dermatitis. However, it is a subjective, time-consuming exam whose technique demands special care and which presents some contraindications, which hamper its use. In a recent study, we showed that the proliferation assay can suitably replace patch testing for the diagnosis of chromium allergy, which had been previously demonstrated only for nickel allergy. In this study, we try to refine the method by reducing the incubation period of cultures for lymphocyte proliferation assays in response to chromium. OBJECTIVE: Develop an alternative or complementary diagnostic test for chromium allergic contact dermatitis. METHODS: We compared the production of 9 cytokines (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 and RANTES) between 18 chromium-allergic patients and 19 controls. RESULTS: Chromium increased the production of IFN-y, IL-5, IL-2 and IL-13 in allergic patients, but only IL-2 and especially IL-13 helped discriminate allergic patients from controls. The sensitivity, specificity and accuracy found with IL-13 were about 80%. CONCLUSIONS: IL-13 and IL-2 detection may be used to diagnose chromium allergy in 2-day cultures. However, in general, the 6-day cultures seem to be superior for this purpose. .


FUNDAMENTOS: O teste de contato permanece como padrão ouro para a identificação do agente causal da dermatite de contato alérgica, mas é um exame subjetivo, que demanda considerável tempo do paciente e do medico, exige cuidados na sua técnica e apresenta algumas contra-indicações que dificultam o seu uso. Em um estudo recente demonstramos que o teste de proliferação pode adequadamente substituir o teste de contato no diagnóstico de alergia ao cromo, algo previamente demonstrado apenas para o níquel. Neste estudo tentamos refinar o método reduzindo o período de incubação das culturas do teste de proliferação para o cromo. OBJETIVO: Desenvolver um método alternativo ao teste de contato para o diagnóstico dermatite de contato alérgica ao cromo. MÉTODOS: Comparamos o estímulo provocado pelo cromo na produção de nove citocinas (IFN-γ, IL2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-17 e RANTES) no sobrenadante das culturas de células do sangue periférico de 18 pacientes alérgicos ao cromo e 19 controles. RESULTADOS: O cromo aumentou a produção de IFN-y, IL-5, IL-2 e IL-13, mas apenas as citocinas IL-2 e principalmente IL-13 foram capazes de discriminar pacientes de controles. A sensibilidade, especificidade e acurácia encontradas com a IL-13 foram de aproximadamente de 80%. CONCLUSÕES: Concluímos que a detecção de IL-2 e IL-13 podem ser útil para o diagnóstico de alergia a cromo na cultura de 2 dias. Todavia, as culturas de 6 dias parecem, de um modo geral, superiores as de 2 dias para esse fim. .


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cromo/toxicidade , Citocinas/sangue , Dermatite Alérgica de Contato/diagnóstico , Testes do Emplastro/métodos , Células Cultivadas , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Fatores de Tempo
12.
An Bras Dermatol ; 88(4): 530-40, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24068123

RESUMO

BACKGROUND: Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. OBJECTIVES: Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. METHODS: An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. RESULTS: Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. CONCLUSIONS: Alcohol abuse, hepatitis C and estrogen intake are prevalent precipitating factors in our porphyria cutanea tarda population; however, hemochromatosis in itself can also contribute to the outbreak of porphyria cutanea tarda, which makes the research for HFE mutations necessary in these patients.


Assuntos
Hemocromatose/genética , Mutação/genética , Porfiria Cutânea Tardia/genética , Adulto , Distribuição por Idade , Alcoolismo/complicações , Cromatografia Líquida , Estrogênios/efeitos adversos , Feminino , Frequência do Gene , Hepatite C/complicações , Humanos , Ferro/sangue , Masculino , Fatores Desencadeantes , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco , Distribuição por Sexo
13.
An Bras Dermatol ; 88(4): 649-51, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24068146

RESUMO

The female flea Tunga penetrans is responsible for a cutaneous parasitosis known as Tungiasis. We report the clinical case of a 12 year-old Caucasian boy who sought treatment in a dermatological private office due to a painful lesion in the plantar area and whose dermoscopic examination, without skin contact, allowed the visualization of parasite's movement inside the skin. The diagnosis of tungiasis is clinical, but it can be aided by in vivo and ex vivo dermoscopic examination of the lesion.


Assuntos
Doenças do Pé/patologia , Tungíase/patologia , Animais , Criança , Dermoscopia , Feminino , Humanos , Masculino , Tunga/anatomia & histologia
14.
An. bras. dermatol ; 88(4): 649-651, ago. 2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-686518

RESUMO

The female flea Tunga penetrans is responsible for a cutaneous parasitosis known as Tungiasis. We report the clinical case of a 12 year-old Caucasian boy who sought treatment in a dermatological private office due to a painful lesion in the plantar area and whose dermoscopic examination, without skin contact, allowed the visualization of parasite's movement inside the skin. The diagnosis of tungiasis is clinical, but it can be aided by in vivo and ex vivo dermoscopic examination of the lesion.


A fêmea da pulga Tunga penetrans é responsável pela dermatose ectoparasitária denominada Tungíase. Relatamos o caso clínico de um adolescente branco de 12 anos de idade, o qual procurou atendimento em consultório dermatológico devido à lesão dolorosa na planta e cujo exame dermatoscópico sem contato com a pele permitiu visualizar o movimento do parasita dentro da pele. O diagnóstico da tungíase é clínico, porém pode ser auxiliado pelo exame dermatoscópico in vivo e ex vivo da lesão.


Assuntos
Animais , Criança , Feminino , Humanos , Masculino , Doenças do Pé/patologia , Tungíase/patologia , Dermoscopia , Tunga/anatomia & histologia
15.
An. bras. dermatol ; 88(4): 530-540, ago. 2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-686529

RESUMO

BACKGROUND: Porphyria cutanea tarda is the most common form of porphyria, characterized by the decreased activity of the uroporphyrinogen decarboxylase enzyme. Several reports associated HFE gene mutations of hereditary hemochromatosis with porphyria cutanea tarda worldwide, although up to date only one study has been conducted in Brazil. OBJECTIVES: Investigation of porphyria cutanea tarda association with C282Y and H63D mutations in the HFE gene. Identification of precipitating factors (hepatitis C, HIV, alcoholism and estrogen) and their link with HFE mutations. METHODS: An ambispective study of 60 patients with PCT was conducted during the period from 2003 to 2012. Serological tests for hepatitis C and HIV were performed and histories of alcohol abuse and estrogen intake were investigated. HFE mutations were identified with real-time PCR. RESULTS: Porphyria cutanea tarda predominated in males and alcohol abuse was the main precipitating factor. Estrogen intake was the sole precipitating factor present in 25% of female patients. Hepatitis C was present in 41.7%. All HIV-positive patients (15.3%) had a history of alcohol abuse. Allele frequency for HFE mutations, i.e., C282Y (p = 0.0001) and H63D (p = 0.0004), were significantly higher in porphyria cutanea tarda patients, compared to control group. HFE mutations had no association with the other precipitating factors. CONCLUSIONS: Alcohol abuse, hepatitis C and ...


FUNDAMENTOS: A porfiria cutânea tardia é a forma mais comum das porfirias e caracteriza-se pela diminuição da atividade da enzima uroporfirinogênio descarboxilase. Há vários relatos da associação das mutações do gene HFE da hemocromatose hereditária com porfiria cutânea tardia no mundo, mas até hoje apenas um estudo foi realizado no Brasil. OBJETIVOS: Estudar a associação da porfiria cutânea tardia com as mutações C282Y e H63D do gene HFE. Identificar os fatores precipitantes (hepatite C, HIV, etilismo e estrógeno) e sua relação com as mutações HFE. MÉTODOS: Estudo ambispectivo de 60 pacientes com porfiria cutânea tardia no período de 2003 a 2012. Investigou-se as sorologias para hepatite C, anti-HIV, histórico de etilismo e ingestão de estrógenos. As mutações HFE foram identificadas com PCR em tempo real. RESULTADOS: A porfiria cutânea tardia predominou no sexo masculino e o etilismo foi o principal fator precipitante. A ingestão de estrógenos foi o único fator precipitante em 25% das mulheres. A hepatite C estava presente em 41,7%. Todos os pacientes com HIV (15,3%) apresentavam etilismo associado. A frequência dos alelos C282Y (p=0,0001) e H63D (p=0,0004) do gene HFE foi significativamente mais elevada nos pacientes com porfiria cutânea tardia em relação à população controle. ...


Assuntos
Adulto , Feminino , Humanos , Masculino , Hemocromatose/genética , Mutação/genética , Porfiria Cutânea Tardia/genética , Distribuição por Idade , Alcoolismo/complicações , Cromatografia Líquida , Estrogênios/efeitos adversos , Frequência do Gene , Hepatite C/complicações , Ferro/sangue , Fatores Desencadeantes , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco , Distribuição por Sexo
16.
An Bras Dermatol ; 88(3): 355-60, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23793207

RESUMO

BACKGROUND: It has been demonstrated that neutrophils, eosinophils and monocytes, under appropriated stimulus, may express tissue factor and therefore, activate the extrinsic pathway of coagulation. We performed a transversal and case-control study of patients with chronic urticaria and patients with psoriasis, in our outpatient clinic to evaluate the production of D-dimer. OBJECTIVE: To evaluate D-dimer serum levels in patients with chronic urticaria and its possible correlation with disease activity. PATIENTS AND METHODS: The study was conducted from October 2010 until March 2011. We selected 37 consecutive patients from our Allergy Unit and Psoriasis Unit, and divided them into three groups for statistical analysis: (i) 12 patients with active chronic urticaria (CU); (ii) 10 patients with chronic urticaria under remission and (iii) 15 patients with psoriasis (a disease with skin inflammatory infiltrate constituted by neutrophils, lymphocytes and monocytes). Another five patients with urticarial vasculitis were allocated in our study, but not included in statistical analysis. The serum levels of D-dimer were measured by Enzyme Linked Fluorescent Assay (ELFA), and the result units were given in ng/ml FEU. RESULTS: Patients with active chronic urticaria had the highest serum levels of D-dimer (p<0.01), when compared to patients with CU under remission and the control group (patients with psoriasis). CONCLUSIONS: Patients with active chronic urticaria have higher serum levels of D-dimer, when compared to patients with chronic urticaria under remission and patients with psoriasis. We found elevated serum levels of D-dimer among patients with urticarial vasculitis.


Assuntos
Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Psoríase/sangue , Urticária/sangue , Vasculite/sangue , Adulto , Idoso , Estudos de Casos e Controles , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
An. bras. dermatol ; 88(3): 355-360, jun. 2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-676238

RESUMO

BACKGROUND: It has been demonstrated that neutrophils, eosinophils and monocytes, under appropriated stimulus, may express tissue factor and therefore, activate the extrinsic pathway of coagulation. We performed a transversal and case-control study of patients with chronic urticaria and patients with psoriasis, in our outpatient clinic to evaluate the production of D-dimer. OBJECTIVE: To evaluate D-dimer serum levels in patients with chronic urticaria and its possible correlation with disease activity. PATIENTS AND METHODS: The study was conducted from October 2010 until March 2011. We selected 37 consecutive patients from our Allergy Unit and Psoriasis Unit, and divided them into three groups for statistical analysis: (i) 12 patients with active chronic urticaria (CU); (ii) 10 patients with chronic urticaria under remission and (iii) 15 patients with psoriasis (a disease with skin inflammatory infiltrate constituted by neutrophils, lymphocytes and monocytes). Another five patients with urticarial vasculitis were allocated in our study, but not included in statistical analysis. The serum levels of D-dimer were measured by Enzyme Linked Fluorescent Assay (ELFA), and the result units were given in ng/ml FEU. RESULTS: Patients with active chronic urticaria had the highest serum levels of D-dimer (p<0.01), when compared to patients with CU under remission and the control group (patients with psoriasis). CONCLUSIONS: Patients with active chronic urticaria have higher serum levels of D-dimer, when compared to patients with chronic urticaria under remission and patients with psoriasis. We found elevated serum levels of D-dimer among patients with urticarial vasculitis. .


FUNDAMENTOS: Tem sido demonstrado que os neutrófilos, eosinófilos e monócitos, sob estímulo apropriado, podem expressar fator tecidual e, portanto, ativar a via extrínseca da coagulação. Realizamos um estudo transversal e caso-controle de pacientes com urticária crônica e pacientes com psoríase em nosso ambulatório para avaliar a produção de dímero-D. OBJETIVO: Avaliar níveis de dímero-D em pacientes com urticária crônica e sua possível correlação com a atividade da doença. PACIENTES E MÉTODOS: O estudo foi conduzido de outubro de 2010 até março de 2011. Nós selecionamos 37 pacientes consecutivos da Unidade de Alergia e Unidade de Psoríase, divididos em três grupos para análise estatística: (i) 12 pacientes com urticária crônica ativa; (ii) 10 pacientes com urticária crônica em remissão e (iii) 15 pacientes com psoríase (uma doença com a pele infiltrado inflamatório constituído por neutrófilos, linfócitos e monócitos). Outros cinco pacientes com vasculite urticariforme foram alocados em nosso estudo, mas não incluídos na análise estatística. Os níveis séricos de D-dímero foram medidos por Enzyme Linked Fluorescent Assay (ELFA), e os resultados foram medidos em ng / ml FEU. RESULTADOS: Os pacientes com urticária crônica ativa tinham níveis séricos mais altos de dímero-D (p <0,01), quando comparados aos pacientes com urticária crônica em remissão e ao grupo controle (pacientes com psoríase). CONCLUSÕES: Os pacientes com urticária crônica ativa têm níveis séricos mais elevados de dímero-D, quando comparados aos pacientes ...


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Psoríase/sangue , Urticária/sangue , Vasculite/sangue , Estudos de Casos e Controles , Doença Crônica , Estudos Transversais
18.
An Bras Dermatol ; 87(3): 408-11, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22714756

RESUMO

BACKGROUND: Leprosy, an infectious disease caused by Mycobacterium leprae, can affect the skin and the peripheral nervous system and, depending on the level of involvement, it can lead to severe deformities. Leprosy is classified into two major groups: paucibacillary (up to five lesions) and multibacillary (more than five lesions). The deformities that appear during the progress of the disease can affect the quality of life. OBJECTIVE: To assess quality of life of patients with paucibacillary leprosy diagnosed and treated early in the outpatients' clinic. METHODS: The Dermatology Life Quality Index questionnaire and ShortForm36 were applied to 49 outpatients undergoing treatment at the Leprosy Multidisciplinary Group of the Hospital das Clínicas of the Faculdade de Medicina of the Universidade de São Paulo. RESULTS: The majority of the patients (63%) did not show impairment of the quality of life, according to the results obtained by the Dermatology Life Quality Index questionnaire. In the questionnaire Short Form-36, the scores assessed showed slight impairment of the quality of life. CONCLUSION: On this study, we can conclude that this group of patients, with paucibacillary leprosy, did not show important impairment of the quality of life. Therefore we can conclude that the earlier the diagnosis and the treatment the lesser the influence on the quality of life.


Assuntos
Hanseníase Paucibacilar/psicologia , Qualidade de Vida/psicologia , Dermatopatias Bacterianas/psicologia , Adolescente , Feminino , Humanos , Masculino , Índice de Gravidade de Doença
19.
An. bras. dermatol ; 87(3): 408-411, May-June 2012. graf, tab
Artigo em Inglês | LILACS | ID: lil-638530

RESUMO

BACKGROUND: Leprosy, an infectious disease caused by Mycobacterium leprae, can affect the skin and the peripheral nervous system and, depending on the level of involvement, it can lead to severe deformities. Leprosy is classified into two major groups: paucibacillary (up to five lesions) and multibacillary (more than five lesions). The deformities that appear during the progress of the disease can affect the quality of life. OBJECTIVE: To assess quality of life of patients with paucibacillary leprosy diagnosed and treated early in the outpatients' clinic. METHODS: The Dermatology Life Quality Index questionnaire and ShortForm36 were applied to 49 outpatients undergoing treatment at the Leprosy Multidisciplinary Group of the Hospital das Clínicas of the Faculdade de Medicina of the Universidade de São Paulo. RESULTS: The majority of the patients (63%) did not show impairment of the quality of life, according to the results obtained by the Dermatology Life Quality Index questionnaire. In the questionnaire Short Form-36, the scores assessed showed slight impairment of the quality of life. CONCLUSION: On this study, we can conclude that this group of patients, with paucibacillary leprosy, did not show important impairment of the quality of life. Therefore we can conclude that the earlier the diagnosis and the treatment the lesser the influence on the quality of life.


FUNDAMENTOS: A hanseníase, doença infecciosa causada pelo Mycobacterium leprae, pode acometer a pele e o sistema nervoso periférico e de acordo com o grau de acometimento, levar a graves deformidades. É classificada em dois grandes grupos: paucibacilar (até cinco lesões) e multibacilar (mais de cinco lesões). As deformidades que podem ocorrer durante a evolução da doença levam ao comprometimento da qualidade de vida. OBJETIVO: Avaliar a qualidade de vida nos pacientes com hanseníase, do grupo paucibacilar, diagnosticados e tratados precocemente e em tratamento ambulatorial. MÉTODOS:Aplicação dos questionários Dermatology Life Quality Index e Short Form-36 a 49 doentes em tratamento no Ambulatório do Grupo Multidisciplinar de Hanseníase do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTADOS: A maioria (63%) dos 49 doentes, não apresentou comprometimento da qualidade de vida, na aplicação do questionário Dermatology Life Quality Index. Quanto ao questionário genérico Short Form-36, os escores alcançados demonstraram pouco comprometimento da qualidade de vida. CONCLUSÃO: O grupo de pacientes estudados com hanseníase paucibacilar mostrou pouco comprometimento da qualidade de vida levando-se em consideração os resultados obtidos nos dois questionários aplicados. Isto nos leva a concluir que quanto mais precoce é o diagnóstico e o tratamento, menor é o acometimento da qualidade de vida.


Assuntos
Adolescente , Feminino , Humanos , Hanseníase Paucibacilar/psicologia , Qualidade de Vida/psicologia , Dermatopatias Bacterianas/psicologia , Índice de Gravidade de Doença
20.
An Bras Dermatol ; 86(3): 419-33, 2011.
Artigo em Inglês, Português | MEDLINE | ID: mdl-21738956

RESUMO

Allergic contact dermatitis is the consequence of an immune reaction mediated by T cells against low molecular weight chemicals known as haptens. It is a common condition that occurs in all races and age groups and affects the quality of life of those who present it. The immunological mechanism of this disease has been reviewed in recent decades with significant advance in its understanding. The metabolism and pathway of the haptens as well as the activation and mechanism of action of the cells responsible for both the immune reaction and its completion are discussed in this article.


Assuntos
Dermatite Alérgica de Contato/imunologia , Citocinas/imunologia , Haptenos/imunologia , Humanos , Células de Langerhans/imunologia , Linfócitos T Reguladores/imunologia
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