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Sasso BM, Vallarelli A, Rosa PS, Belone A, Velho P, Cintra ML. Macrophage immunophenotypes in Jorge Lobo's disease and lepromatous leprosy- A comparative study. Microb Pathog 2024; 190:106610. [PMID: 38484920 DOI: 10.1016/j.micpath.2024.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 03/24/2024]
Abstract
Jorge Lobo's disease (JLD) and lepromatous leprosy (LL) share several clinical, histological and immunological features, especially a deficiency in the cellular immune response. Macrophages participate in innate and adaptive inflammatory immune responses, as well as in tissue regeneration and repair. Macrophage function deficiency results in maintenance of diseases. M1 macrophages produce pro-inflammatory mediators and M2 produce anti-inflammatory cytokines. To better understand JLD and LL pathogenesis, we studied the immunophenotype profile of macrophage subtypes in 52 JLD skin lesions, in comparison with 16 LL samples, using a panmacrophage (CD68) antibody and selective immunohistochemical markers for M1 (iNOS) and M2 (CD163, CD204) responses, HAM56 (resident/fixed macrophage) and MAC 387 (recently infiltrating macrophage) antibodies. We found no differences between the groups regarding the density of the CD163, CD204, MAC387+ immunostained cells, including iNOS, considered a M1 marker. But HAM56+ cell density was higher in LL samples. By comparing the M2 and M1 immunomarkers in each disease separately, some other differences were found. Our results reinforce a higher M2 response in JLD and LL patients, depicting predominant production of anti-inflammatory cytokines, but also some distinction in degree of macrophage activation. Significant amounts of iNOS + macrophages take part in the immune milieu of both LL and JLD samples, displaying impaired microbicidal activity, like alternatively activated M2 cells.
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Affiliation(s)
- B M Sasso
- State University of Campinas (UNICAMP), Campinas, Brazil.
| | - Afa Vallarelli
- State University of Campinas (UNICAMP), Campinas, Brazil
| | - P S Rosa
- Lauro de Souza Lima Institute (ILSL), Bauru, Brazil
| | - Aff Belone
- Lauro de Souza Lima Institute (ILSL), Bauru, Brazil
| | - Penf Velho
- State University of Campinas (UNICAMP), Campinas, Brazil
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Lovato BH, Fogagnolo L, Souza EMD, Silva LJBD, Velho PENF, Cintra ML, Teixeira F. IL-1β and IL-17 in cutaneous lupus erythematous skin biopsies: could immunohistochemicals indicate a tendency towards systemic involvement? An Bras Dermatol 2024; 99:66-71. [PMID: 37783618 DOI: 10.1016/j.abd.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/06/2023] [Accepted: 02/01/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Only a fraction of patients with cutaneous lupus erythematosus (CLE) will eventually progress toward systemic disease (SLE). OBJECTIVE To find inflammatory biomarkers which could predict the progression of cutaneous lupus erythematosus (CLE) into systemic lupus erythematosus (SLE) using immunohistochemical (IHC) assays. METHODS Immunohistochemical markers for cytotoxic, inflammatory, and anti-inflammatory responses and morphometric methods were applied to routine paraffin sections of skin biopsies, taken from lesions of 59 patients with discoid lupus, subacute lupus, and lupus tumidus. For the diagnosis of SLE, patients were classified by both the American College of Rheumatology (ACR-82) and the Systemic Lupus International Collaborating Clinics (SLICC-12) systems. RESULTS Skin samples from CLE/SLE+patients presented higher expression of IL-1β (ARC-82: p=0.024; SLICC-12: p=0.0143) and a significantly higher number of cells marked with granzyme B and perforin (ARC: p=0.0097; SLICC-12: p=0.0148). Biopsies from CLE/SLE- individuals had higher expression of IL-17 (ARC-82: p=0.0003; SLICC-12: p=0.0351) and presented a positive correlation between the density of granzyme A+and FoxP3+ cells (ARC-82: p=0.0257; SLICC-12: p=0.0285) and CD8+ cells (ARC-82: p=0.0075; SLICC-12: p=0.0102), as well as between granulysin-positive and CD8+ cells (ARC-82: p=0.0024; SLICC-12: p=0.0116). STUDY LIMITATIONS Patients were evaluated at a specific point in their evolution and according to the presence or not of systemic disease. The authors cannot predict how many more, from each group, would have evolved towards SLE in the following years. CONCLUSIONS In this cohort, immunohistochemical findings suggested that patients with a tendency to systemic disease will show strong reactivity for IL-1β, while those with purely cutaneous involvement will tend to express IL-17 more intensely.
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Affiliation(s)
- Barbara Hartung Lovato
- Department of Pathology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
| | - Leticia Fogagnolo
- Department of Pathology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Elemir Macedo de Souza
- Department of Dermatology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | | | - Maria Leticia Cintra
- Department of Pathology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Fernanda Teixeira
- Department of Pathology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Secamilli EN, Drummond MR, Serrano JYM, Stelini RF, Cintra ML, Velho PENF. Is Bartonella sp. infection relevant in hematological malignancies in HIV-negative patients? A literature review. Leuk Res Rep 2023; 21:100402. [PMID: 38192503 PMCID: PMC10772291 DOI: 10.1016/j.lrr.2023.100402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/22/2023] [Accepted: 11/23/2023] [Indexed: 01/10/2024] Open
Abstract
Bartonelloses are diseases caused by Bartonella sp., transmitted to humans by blood sucking arthropod vectors. Clinical presentations include bacillary angiomatosis, cat scratch disease and atypical forms. We performed a review of cases of bartonelloses and hematological malignancies published in HIV-negative patients. Terms used were Bartonella or Bacillary Angiomatosis and Leukemia, Lymphoma, Multiple Myeloma, or Cancer. Fifteen cases met our criteria. Clinical presentations included bacillary angiomatosis, chronic fever, chronic lymphadenopathy, osteomyelitis, neuroretinitis, chronic anemia and hepatosplenic peliosis. Fourteen patients were asymptomatic after antibiotic therapy, and one died before antibiotic treatment. Clinicians should be suspicious of Bartonella sp. infections in immunocompromised patients.
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Affiliation(s)
- Elisa Nunes Secamilli
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Marina Rovani Drummond
- Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Juliana Yumi Massuda Serrano
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Rafael Fantelli Stelini
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Maria Leticia Cintra
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Botega AADR, Amorim CV, Teixeira F, Borges Figueira de Mello CD, Stelini RF, Velho PENF, Cintra ML. Scarring versus Non-Scarring Alopecia: An Interobserver Histopathological Reproducibility Study. Skin Appendage Disord 2023; 9:34-41. [PMID: 36643191 PMCID: PMC9833003 DOI: 10.1159/000526966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Distinguishing scarring (SA) versus non-scarring alopecia (NSA) may not be a simple procedure on either clinical or histopathological views. Aims We sought to study the interobserver variability in the histopathological assessment of SA versus NSA, including clinical-pathological considerations. Methods Two dermatopathologists independently interpreted the same set of 100 specimens (89 patients). The samples were serial sectioned and stained by hematoxylin and eosin and Verhöeff methods. The patients' mean age was 46 years, with 13 being males and 76 females. Results In 16/100 samples, there was no consensus among the two examiners regarding SA versus NSA (weighted kappa = 0.6583; 95% CI); 3/16 patients were re-biopsied, and in the second sample, consensus was reached. In 76/89 patients, the anatomopathological examination was helpful in defining the SA versus NSA subtype. Of the 84 samples in which there was interobserver agreement, 4 which had been considered scarring in the routine pathological report were re-classified as non-scarring, whereas one biopsy, previously diagnosed as non-scarring, was now considered cicatricial due to the newly found areas of lichenoid inflammation in the infundibular epithelium. Discussion The ideal scalp examination may require deep serial biopsy sectioning, elastic tissue stain, re-biopsy, and strict clinical-evolutive correlation.
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Affiliation(s)
| | - Carolina Viza Amorim
- Department of Pathology, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | - Fernanda Teixeira
- Department of Pathology, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | | | - Rafael Fantelli Stelini
- Department of Pathology, School of Medical Sciences, State University of Campinas, Campinas, Brazil
| | | | - Maria Leticia Cintra
- Department of Pathology, School of Medical Sciences, State University of Campinas, Campinas, Brazil
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Charakida A, Teixeira F, Kubba F, Anton A, Schulman D, Cintra ML. A rare manifestation of scalp sarcoidosis. Int J Dermatol 2023; 62:e9-e10. [PMID: 35781880 DOI: 10.1111/ijd.16329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/05/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Fernanda Teixeira
- Department of Dermatology, London Northwest Healthcare Trust, London, UK.,School of Medical Sciences, UNICAMP, Campinas, Brazil
| | - Faris Kubba
- Department of Pathology, London Northwest Healthcare Trust, London, UK
| | - Andreea Anton
- Department of Dermatology, London Northwest Healthcare Trust, London, UK
| | - Daniel Schulman
- Department of Dermatology, London Northwest Healthcare Trust, London, UK
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Suzuki N, Cintra FF, Cintra ML, Maciel MG, Amstalden E, Teixeira F, Kubba F. "A case of vanishing bone disease complicated by chylothorax- diagnosis and treatment". JRSM Open 2022; 13:20542704221103912. [PMID: 35774987 PMCID: PMC9237928 DOI: 10.1177/20542704221103912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 16-year old girl with Gorham-Stout disease is presented. She had progressive replacement of the bones of her left arm and shoulder girdle by fibroadipose tissue and numerous proliferated, non-neoplastic, lymphatic channels. The clinico-pathologic features of this condition are discussed, as are its possible complications and available therapeutic modalities.
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Affiliation(s)
- N Suzuki
- Department of Dermatology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - F F Cintra
- Department of Orthopedics, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - M L Cintra
- Department of Pathology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - M G Maciel
- Department of Dermatology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Emi Amstalden
- Department of Pathology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - F Teixeira
- Department of Pathology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - F Kubba
- Department of Pathology, London Northwest University Healthcare NHS Trust, UK
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Soares AB, de Araújo VC, Passador-Santos F, Thomaz LA, de Freitas ALS, Mautoni MC, Stelini RF, Cintra ML. Uncommon Pigmented Carcinoma In Situ: Case Report and Brief Review. Clin Pathol 2021; 14:2632010X211009819. [PMID: 33959706 PMCID: PMC8064661 DOI: 10.1177/2632010x211009819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/13/2021] [Indexed: 11/24/2022]
Abstract
Pigmented lesions of the oral mucosa encompass several benign and malignant conditions that may be a matter of concern under both clinical and histopathological views. We reported a case of a 62-year-old woman, presenting with an asymptomatic, deeply pigmented lesion on the soft palate. On examination, it appeared asymmetrical, with irregular borders and an area of ulceration. A biopsy, taken to rule out melanoma, revealed a pigmented carcinoma in situ. Throughout the tumor thickness, numerous interspersed melanocytes were found that did not extend to neighboring epithelium. These were large, richly dendritic, and presented abundance of melanin granules and small nuclei. Mild melanin incontinence was found. Scanty transfer of pigment to dysplastic epithelial cells was found through Fontana Masson staining. On immunohistochemical analyses, there were pancytokeratin-stained tumor epithelial cells; increased cell proliferation throughout the entire thickness of the tumor was emphasized by Ki-67 immunomarking. P16 was negative. The dendritic cells were selectively stained for S-100, HMB45 and Melan A. Wide spectrum in situ hybridization for human papillomavirus (HPV) was negative. Unfortunately, following diagnosis, the patient refused any treatment option. Pigmented squamous cell carcinoma with melanocyte colonization must be taken into account in the differential diagnosis of pigmented lesions of the oral cavity.
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Affiliation(s)
- Andresa Borges Soares
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, Brazil
| | | | - Fabricio Passador-Santos
- Department of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas, Brazil
| | | | | | | | - Rafael Fantelli Stelini
- Department of Pathology, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Maria Leticia Cintra
- Department of Pathology, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
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Palo JS, Suzuki NN, Galusni Senna B, Cintra ML, Helena Buffo T, Machado de Moraes A. 18435 Extramammary Paget disease of the eyelid with clivus malignancy. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sala ACA, Crespo ACF, Stelini RF, Leite O, Moraes AM, Velho PENF, Souza EM, Cintra ML. Chronic Venous Insufficiency as a Predisposing Factor for Basal Cell Carcinoma on Legs. Ann Vasc Surg 2020; 68:185-191. [PMID: 32422291 DOI: 10.1016/j.avsg.2020.04.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The main risk factor associated with basal cell carcinomas (BCCs) is believed to be exposure to ultraviolet radiation (UVR). In the case of lower limb BCC, the frequency is higher in women, possibly because of greater exposure of the leg to UVR. Chronic venous insufficiency (CVI), also more common in women, may have some association with leg BCCs. METHODS We retrospectively evaluated the histopathological features of leg BCCs removed between 1993 and 2017 in a tertiary referral center. The patients' clinical data were obtained from medical records, considering, in particular, CVI. RESULTS We selected 149 patients with leg BCCs, predominately occurring in elderly Caucasian women. Of those, 71 had a clinical diagnosis of CVI in whom the clinical tumor size and frequency of recurrences were significantly higher than patients without CVI. There was an association between clinical diagnosis of CVI and histological findings of (1) follicular induction in epidermis and (2) distal sweat duct hyperplasia. CONCLUSIONS CVI, besides the already known UVR exposure, is probably associated with leg BCCs and may determine a worse BCC course.
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Affiliation(s)
| | | | | | - Oriete Leite
- Department of Dermatology, Medical School, Unicamp, Campinas, SP, Brazil
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Sasso BM, Florence MEB, Magalhaes RF, Velho PENF, de Souza EM, Cintra ML, Stelini RF. Herpes simplex virus mucocutaneous tumoural lesions - Systematic review. J Clin Virol 2019; 123:104246. [PMID: 31927151 DOI: 10.1016/j.jcv.2019.104246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 12/09/2019] [Accepted: 12/16/2019] [Indexed: 02/01/2023]
Abstract
The goal was to characterize the clinical-epidemiological profile of patients with mucocutaneous tumoural herpes simplex virus (MCT HSV) lesions across the world. Two researchers extracted and independently reviewed data from the literature search engine PubMed/MEDLINE through October 2018. From 110 reported patients, the following data were available: the patients' ages ranged from 7 to 76 years; the majority was male (62.73 %-69/110) and immunosuppression was found in 97.25 % (106/109, missing 1) cases, of whom 88 were HIV- related. Lesions size varied from 0.2-13 cm, settling in the anogenital region in 76.36 % (84/110) patients; 84.13 % (53/63, missing 47) complained of pain and multiple recurrences were found in 44.94 % (40/89, missing 21) cases. On clinical basis, the initial hypothesis was neoplasia in 36/53 patients. Histopathological diagnosis was achieved in 90 % (90/100, missing 10) cases and was sample size-dependent. Type 2 HSV was detected in 86.07 % (68/79, missing 31) lesions. MCT HSV lesions recurrence after treatment was reported in 33.96 % (18/53, missing 57) patients. Pathophysiology is poorly understood. Physicians should be aware of MCT HSV lesions in immunosuppressed patients to avoid inappropriate therapeutic strategies.
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Affiliation(s)
- Bruna Morassi Sasso
- Pathology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil; Dermatology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil
| | - Michelle Etienne Baptistella Florence
- Pathology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil; Dermatology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil
| | - Renata Ferreira Magalhaes
- Dermatology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil
| | - Paulo Eduardo Neves Ferreira Velho
- Dermatology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil
| | - Elemir Macedo de Souza
- Pathology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil; Dermatology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil
| | - Maria Leticia Cintra
- Pathology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil
| | - Rafael Fantelli Stelini
- Pathology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil.
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da Silva DLF, Toribio JM, Cintra ML, Magalhaes RF, Padoveze EH. Subungual Acral Lentiginous Melanoma of the Fifth Toe. Skin Appendage Disord 2019; 5:401-404. [PMID: 31799273 DOI: 10.1159/000503039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/29/2019] [Indexed: 11/19/2022] Open
Abstract
Acral lentiginous melanoma is rare in Caucasians, but it is the most common among individuals with a higher phototype, such as Blacks and Asians. It is usually presented under the palmoplantar and/or nail region. Subungual melanoma is an acral lentiginous melanoma subtype in which the initial diagnostic approach does not have a consensus. We report a case of a woman with tumoral melanocytic lesion on the fifth toenail, of insidious growth, where the amputation of the nail apparatus technique was used as an excisional biopsy for an extensive lesion. The patient is followed up in an outpatient clinic setting without lymph node or distance metastasis.
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Lopes de Oliveira LM, Batista LHC, Neto APDS, Silva LB, Cimões R, Leão JC, Cintra ML, Ribeiro CMB. Oral Lichenoid Lesion Manifesting as Desquamative Gingivitis: Unlikely Association? Case Report. Open Dent J 2018; 12:679-686. [PMID: 30369977 PMCID: PMC6182885 DOI: 10.2174/1745017901814010679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/19/2018] [Accepted: 09/03/2018] [Indexed: 01/13/2023] Open
Abstract
Introduction: The aim of this report is to present a clinical case of oral lichenoid lesions associated with amalgam restorations with the presence of desquamative gingivitis for a nine months follow up period. Case Report: The histopathologic characteristics and direct immunofluorescence were compatible with Oral Lichenoid Lesion (LLO). Diagnosis was based on a synthesis of all available information, including medical history, clinical examination, histopathology and the results of specific tests, such as the patch test, which confirmed allergy to thimerosal, an organic compound of mercury. Discussion: The replacement of amalgam restorations has brought improvements to the instrument, as evidenced by the disappearance of desquamative gingivitis, aspect erythematosus and erosive lesions. The fading does not complete the same, however, indicates the need to continue has been under continuous observation, the patient, having in view the possibility of the existence of an underlying lichen planus.
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Affiliation(s)
- Lívia Maria Lopes de Oliveira
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | | | | | - Luciano Barreto Silva
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Renata Cimões
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Jair Carneiro Leão
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Maria Leticia Cintra
- Medical Sciences College, University of Campinas - FCM UNICAMP, Campinas, Brazil
| | - Camila Maria Béder Ribeiro
- Department of Pathology, Faculty of Dentistry, Cesmac University Center, Cônego Machado, 918, Farol CEP: 57051-160, Maceió, Alagoas, Brazil
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Alexandre G, Egal E, Shinomia S, Passos H, Nascimento J, Cintra ML, Altemani A, Mariano F. 75 Adipophilin Expression in the Progression of Melanomas. Am J Clin Pathol 2018. [DOI: 10.1093/ajcp/aqx116.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Passos H, Egal E, Shinomia S, Alexandre G, Cintra ML, Amstalden E, Altemani A, Mariano F. 76 Retrospective Study of Sarcomas in a Brazilian Institution: Clinical-Pathological Analysis. Am J Clin Pathol 2018. [DOI: 10.1093/ajcp/aqx116.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mattos KPH, Cintra ML, Gouvêa IR, Ferreira LÁ, Velho PENF, Moriel P. Skin hyperpigmentation following intravenous polymyxin B treatment associated with melanocyte activation and inflammatory process. J Clin Pharm Ther 2017; 42:573-578. [PMID: 28497462 DOI: 10.1111/jcpt.12543] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/03/2017] [Indexed: 11/28/2022]
Abstract
What is known and objective Polymyxins were widely used until the 1960s; however, they fell into disfavour owing to their toxicity. The subsequent growth of infections caused by multidrug-resistant Gram-negative bacteria has led to renewed use of this class of antimicrobials in clinical practice. Acquired skin hyperpigmentation (SH) following intravenous polymyxin B treatment has been previously reported, but little is known about its pathogenesis, clinical course and treatment. To improve understanding of these issues, we conducted a prospective study of adult patients receiving intravenous polymyxin B treatment. Methods Patients receiving intravenous polymyxin B treatment were followed throughout the course of treatment. Clinical, dermatoscopic, histologic and immunohistochemical skin properties of patients who presented with SH were studied. Results and discussion Skin hyperpigmentation was noted in 8% of patients (n=20/249); however, clinical, dermatoscopic, histologic and immunohistochemical examinations were performed only in three patients for whom the consent of relatives was obtained. Histologic and immunohistochemical findings showed an abundant melanocyte-pigmented dendritic network. Langerhans cells' hyperplasia and dermal IL-6 overexpression were also found, presumably for an inflammatory process due to polymyxin B use. As polymyxin B causes the release of histamine, which is known for its melanogenic effect, it is possible that skin darkening is associated with this inflammatory mediator. What is new These clinical and dermatoscopic findings contribute to a better understanding of how the pigmentary reaction manifests following intravenous polymyxin B treatment. Conclusion We concluded that hyperpigmentation due to intravenous polymyxin B treatment is associated with an inflammatory process and subsequent melanocyte activation. Although the pigmentary disorder neither influences the outcome of the therapy nor warrants discontinuation of treatment, it nevertheless considerably affects the patient's quality of life.
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Affiliation(s)
- K P H Mattos
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - M L Cintra
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - I R Gouvêa
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
| | - L Á Ferreira
- Dermatoscopy and melanoma Department of the Clinical Hospital of University of Campinas, Sao Paulo, SP, Brazil
| | - P E N F Velho
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Dermatoscopy and melanoma Department of the Clinical Hospital of University of Campinas, Sao Paulo, SP, Brazil
| | - P Moriel
- Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
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16
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Fogagnolo L, de Souza EM, Blotta MHDSL, Senna CG, Silva CAM, Cintra ML. Immunomodulation in cutaneous lupus erythematosus subsets. J Dermatol Sci 2016; 84:225-227. [PMID: 27492812 DOI: 10.1016/j.jdermsci.2016.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 07/07/2016] [Accepted: 07/27/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Leticia Fogagnolo
- Pathology Department, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, CEP 13083-887 Campinas, SP, Brazil.
| | - Elemir Macedo de Souza
- Dermatology Department, Medical Sciences School, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, CEP 13083-887 Campinas, SP, Brazil.
| | - Maria Heloísa de Souza Lima Blotta
- Clinical Pathology Department, Medical Sciences School, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, CEP 13083-887 Campinas, SP, Brazil.
| | - César Galusni Senna
- Pathology Department, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, CEP 13083-887 Campinas, SP, Brazil.
| | - Cleide Aparecida Moreira Silva
- Statistics division, Research Committee, Medical Sciences School, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, CEP 13083-887 Campinas, SP, Brazil.
| | - Maria Leticia Cintra
- Pathology Department, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, CEP 13083-887 Campinas, SP, Brazil.
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17
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Ruas LP, Pereira RM, Braga FG, Lima XT, Mamoni RL, Cintra ML, Schreiber AZ, Calich VLG, Blotta MHSL. Severe Paracoccidioidomycosis in a 14-Year-Old Boy. Mycopathologia 2016; 181:915-920. [PMID: 27364896 DOI: 10.1007/s11046-016-0035-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
Abstract
Paracoccidioidomycosis (PCM) is the most important systemic mycoses in Latin America. We describe a severe case of paracoccidioidomycosis in a 14-year-old boy, with a rapid disease progression. The fungal strain was isolated and inoculated into a T and/or B cell immunocompromised mice, which revealed a highly virulent strain. The case report presented herein emphasizes the importance of considering PCM in the differential diagnosis of patients with other infectious diseases in endemic areas and highlights a novel isolate.
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Affiliation(s)
- L P Ruas
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Campinas, São Paulo, 13083-878, Brazil
| | - R M Pereira
- Department of Pediatrics, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - F G Braga
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Campinas, São Paulo, 13083-878, Brazil
| | - X T Lima
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Campinas, São Paulo, 13083-878, Brazil.,School of Medicine, University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
| | - R L Mamoni
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Campinas, São Paulo, 13083-878, Brazil
| | - M L Cintra
- Department of Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - A Z Schreiber
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Campinas, São Paulo, 13083-878, Brazil
| | - V L G Calich
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - M H S L Blotta
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Campinas, São Paulo, 13083-878, Brazil.
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18
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Takata Pontes L, Fantelli Stelini R, Cintra ML, Magalhães RF, Velho PENF, Moraes AM. The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital. Clinics (Sao Paulo) 2015; 70:721-5. [PMID: 26602517 PMCID: PMC4642494 DOI: 10.6061/clinics/2015(11)01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal. METHODS The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications. RESULTS Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications. CONCLUSION Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating "skip areas" and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.
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Affiliation(s)
- Luciana Takata Pontes
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
| | - Rafael Fantelli Stelini
- Patologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, SP, Brazil
| | - Maria Leticia Cintra
- Patologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, SP, Brazil
| | - Renata Ferreira Magalhães
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
| | - Paulo Eduardo N F Velho
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
| | - Aparecida Machado Moraes
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
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19
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Bittencourt C, Ferraro DA, Soares TCB, Moraes AM, Cintra ML. Chronic telogen effluvium and female pattern hair loss are separate and distinct forms of alopecia: a histomorphometric and immunohistochemical analysis. Clin Exp Dermatol 2014; 39:868-73. [PMID: 25156792 DOI: 10.1111/ced.12406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chronic telogen effluvium (CTE), a poorly understood condition, can be confused with or may be a prodrome to female pattern hair loss (FPHL). The pathogenesis of both is related to follicle cycle shortening and possibly to blood supply changes. AIM To analyze a number of histomorphometric and immunohistochemical findings through vascular endothelial growth factor (VEGF), Ki-67, and CD31 immunostaining in scalp biopsies of 20 patients with CTE, 17 patients with mild FPHL and 9 controls. METHODS Ki-67 index and VEGF optical density were analyzed at the follicular outer sheath using ImageJ software. CD31 microvessel density was assessed by a Chalkley grid. RESULTS Significant follicle miniaturization and higher density of nonanagen follicles were found in FPHL, compared with patients with CTE and controls. Ki-67+ index correlated positively with FPHL histological features. The FPHL group showed the highest VEGF optical density, followed by the CTE and control groups. No differences were found in CD31 microvessel density between the three groups. CONCLUSIONS Histomorphometric results establish CTE as a distinct disorder, separate from FPHL from its outset. Its pathogenic mechanisms are also distinct. These findings support the proposed mechanism of 'immediate telogen release' for CTE, leading to cycle synchronization. For FPHL, accelerated anagen follicular mitotic rates and, thus, higher Ki-67 and VEGF values, would leave less time for differentiation, resulting in hair miniaturization.
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Affiliation(s)
- C Bittencourt
- Department of Pathology, Unicamp, Campinas, São Paulo, Brazil
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20
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Moraes PC, Noce CW, Thomaz LA, Cintra ML, Correa MEP. Pigmented lichenoid drug eruption secondary to chloroquine therapy: an unusual presentation in lower lip. Minerva Stomatol 2011; 60:327-332. [PMID: 21666569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Antimalarial drugs, like chloroquine, may produce hyperpigmentation of the oral mucosa, affecting most commonly the palate. Its pathogenesis is not clear; an increased production of melanin is currently believed to be the cause of this oral manifestation. The purpose of this study was to report a case of atypical oral mucosal hyperpigmentation secondary to antimalarial therapy. A 66-year-old, dark skinned woman was evaluated for oral pigmentation. The patient had a history of chloroquine therapy, and presented a diffuse blue-gray pigmentation in the hard palate and, mainly, in the lower lip. Diagnostic hypothesis were of physiologic pigmentation, drug-induced pigmentation, pigmentation associated with systemic diseases, smoker's melanosis and post-inflammatory pigmentation. Incisional biopsy was conducted and histopathological examination revealed lichenoid dermatitis and pigment incontinence. Fontana-Masson staining was positive for melanin, but Perl's iron staining was negative. The histopathological diagnosis was consistent with melanin incontinence related to drug-induced lichenoid reaction secondary to chloroquine therapy. Adequate correlation of clinical and microscopic aspects was essential for the definitive diagnosis, especially in atypical cases. This diagnosis is of great relevance for the patient, since the oral manifestation might be an early sign of ocular complications due to antimalarial therapy. Therefore, the identification of these oral manifestations indicates regular evaluations by an ophtalmologist, preventing greater complications of antimalarial therapy for the patient.
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Affiliation(s)
- P C Moraes
- Department of Stomatology and Oral and Maxillofacial Surgery, São Leopoldo Mandic Dental School Campinas, Brazil
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21
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Cintra ML, Silva ACR, Maeda DEM, Teixeira F. Papular hyperplasia of the follicular infundibulum after intense pulsed light treatment for photoaging. Dermatol Surg 2009; 35:2046-9. [PMID: 19747202 DOI: 10.1111/j.1524-4725.2009.01332.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Leticia Cintra
- Department of Pathology, Medical School, Universidade Estadual de Campinas, Brazil
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22
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Abstract
The purpose of this study was to investigate clinical and histomorphometric features of cat skin under long-term solar exposure. Ear skin of 34 Domestic Shorthair cats that were chronically exposed to sun was classified as follows: group 0, normal (n = 13); group 1, initial stage of photodamage (PD) (n = 10); group 2, advanced stage of PD (n = 11). Histologic sections were examined independently by 2 pathologists, and epidermal thickness, adnexal unit area, and dermal cellularity were assessed by morphometry. A positive correlation was obtained between age, degree of edema and sclerosis in the upper dermis, telangiectases, squamatization of basal keratinocytes, and epidermis thickness and the degree of PD. The area occupied by adnexal structures in the dermis diminished with increased PD. Dermal sclerosis and edema best separated the 3 groups. The results indicated a high level of skin hypersensitivity to sun rays in cats. The findings may be useful for clinical testing and in general veterinary pathology and dermatology.
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Affiliation(s)
- E M P Almeida
- Department of Pathology, Veterinary Division, State University of Campinas (UNICAMP), São Paulo, Brazil
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23
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Puggina J, Andrade LALA, Souza EM, Cintra ML. Comparison of vulvar skin diseases in black and white women: a histopathological study. J Eur Acad Dermatol Venereol 2008; 22:1391-2. [PMID: 18331314 DOI: 10.1111/j.1468-3083.2008.02654.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Teixeira F, Cintra ML, Arenas R, Charakida A, Dominguez L, Chu AC. Is there a role for myofibroblasts in hair regrowth in alopecia areata? Int J Dermatol 2008; 46:1305-6. [PMID: 18173530 DOI: 10.1111/j.1365-4632.2007.03497.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Magalhães RF, Velho PENF, Machado de Moraes A, Cintra ML, Biral AC, Kraemer MHS, Macedo de Souza E. Linear psoriasis in Brazilian children and HLA haplotypes. J Eur Acad Dermatol Venereol 2007; 21:1439-40. [DOI: 10.1111/j.1468-3083.2007.02255.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Magalhaes RF, Cristina Biral A, Morita IH, Cintra ML, Souza EM, Kraemer MHS. 162-P: Human MHC gene polymorphism in relation to Bullous pemphigoid and psoriasis vulgaris. Hum Immunol 2007. [DOI: 10.1016/j.humimm.2007.08.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Lira M, Schenka AA, Magna LA, Cotta AC, Cintra ML, de Souza EM, Brousset P, Vassallo J. Diagnostic value of combining immunostaining for CD3 and nuclear morphometry in mycosis fungoides. J Clin Pathol 2007; 61:209-12. [PMID: 17496190 DOI: 10.1136/jcp.2007.048553] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mycosis fungoides (MF) is the most common skin lymphoid neoplasm. In initial stages, differential diagnosis of MF from other benign dermal lymphoid infiltrates (BDLI) may be impossible on morphological basis alone. In previous studies, only deletion of CD7 in MF proved to be of diagnostic help, but not the ratio between immunoexpression of CD4 and CD8. METHODS 30 cases of MF and 11 cases of BDLI were analysed, in order to compare morphometric parameters, which could be of diagnostic aid. As CD7 is frequently deleted in MF, immunohistochemical detection of T-cells was made using an antibody to CD3. Images of 100 CD3-positive cells per case in both groups were captured and analysed using a simple computer program for nuclear perimeter, area, diameter and nuclear contour index. RESULTS All parameters showed statistically significant higher values for MF. Area was the variable with the strongest discriminating power between the two groups of patients. Thus even if morphological evaluation is not accurate to distinguish benign versus malignant dermal lymphoid infiltrates, due to the variability of size and shape of these cells, a more sensitive method promptly shows this difference. CONCLUSION Results suggest that morphometry of CD3-positive lymphoid cells may add valuable information in the differential diagnosis of MF and benign dermatoses.
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Affiliation(s)
- M Lira
- Faculty of Medical Sciences, State University of Campinas, Unicamp, Campinas, São Paulo, Brazil
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28
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Herreros FOC, Cintra ML, Adam RL, de Moraes AM, Metze K. Remodeling of the human dermis after application of salicylate silanol. Arch Dermatol Res 2007; 299:41-5. [PMID: 17333223 DOI: 10.1007/s00403-007-0739-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Revised: 11/11/2006] [Accepted: 01/16/2007] [Indexed: 10/23/2022]
Abstract
Recently, a controlled double-blind study in patients with photo-aged facial skin demonstrated the beneficial role of oral intake of silanol for skin, hair and nails. The aim of our pilot study was to investigate histologic alterations in human skin after injection of silanol. Seven healthy female caucasian volunteers with a moderate degree of photoaged skin received ten sessions of weekly injections of 0.1% salicylate silanol in the left ventral lateral forearm. The histologic features of punch biopsies of the treated area and the nontreated contralateral arm were compared and the collagen and elastic fibers quantified. Texture analysis was performed on digitalized microscopic images by analyzing the Sarkar fractal dimension or amplitudes (inertia values) after Fast Fourier transformation. The treated area revealed a statistically significant increase of the density of both collagen and elastic fibers. Texture analysis showed more compact and homogeneously distributed collagen fibers after silicon injection. Our results suggest that the application of silicon may stimulate the production of collagen and elastic fibers leading to remodeling of the dermal fiber architecture, which may explain the improvement of the skin surface observed in clinical studies.
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Affiliation(s)
- F O C Herreros
- Dermatology Unit, Department of Clinical Medicine, Faculty of Medicine, State University of Campinas, Campinas, Brazil
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29
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Auada MP, Puzzi MB, Cintra ML, Steiner CE, Alexandrino F, Sartorato EL, Aguiar TS, Azulay RD, Carney G, Rizzo WB. Sjögren-Larsson syndrome in Brazil is caused by a common c.1108-1G-->C splice-site mutation in the ALDH3A2 gene. Br J Dermatol 2006; 154:770-3. [PMID: 16536828 PMCID: PMC3055656 DOI: 10.1111/j.1365-2133.2006.07135.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M P Auada
- Department of Internal Medicine, Medical School, State University of Campinas, SP, Brazil.
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31
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França AEDC, Salvino LKB, Leite SHR, Ferraz JGP, Rocha TDS, Cintra ML, Velho PEN, Souza EM. Pyoderma gangrenosum as first clinical manifestation of gastric adenocarcinoma. J Eur Acad Dermatol Venereol 2006; 20:440-1. [PMID: 16643144 DOI: 10.1111/j.1468-3083.2006.01440.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown etiology characterized by typical skin ulcers. It may be related to systemic disorders but its association with solid tumors is very unusual. In this setting, we describe a patient in whom PG was the first and isolated manifestation of advanced gastric adenocarcinoma.
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Affiliation(s)
- A E da Costa França
- Department of Dermatology, Campinas State University, Campinas, São Paulo, Brazil.
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32
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Herreros FOC, Cintra ML, Macedo de Souza E, Velho PENF. Lax skin masses in a 47-year-old woman.. ACTA ACUST UNITED AC 2005; 141:1595-600. [PMID: 16365268 DOI: 10.1001/archderm.141.12.1595-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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33
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Alborghetti MR, Corrêa MEP, Adam RL, Metze K, Coracin FL, de Souza CA, Cintra ML. Late effects of chronic graft-vs.-host disease in minor salivary glands. J Oral Pathol Med 2005; 34:486-93. [PMID: 16091116 DOI: 10.1111/j.1600-0714.2005.00347.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The established pathologic criteria for minor salivary gland (MSG) involvement in chronic graft-vs.-host disease (cGVHD) could play a role in monitoring response to therapy. METHODS We evaluated MSG sequential biopsies during cGVHD therapy in 14 allogeneic bone marrow transplantation (BMT) patients. Nine patients that did not develop GVHD after BMT entered the control group. Biopsies were examined using hematoxylin-eosin, Periodic acid-Schiff (PAS) and leukocyte common antigen staining. RESULTS A significant loss of PAS+ acinar volume was observed at the diagnosis of cGVHD as much as at the end of treatment when compared with the control group. In the second evaluation, the inflammatory infiltrate was still greater than control group. CONCLUSIONS The results suggest that persistent xerostomia after cGVHD treatment is because of maintenance of lymphocytic infiltrate and consequent absence of MSG secretory unit recovery. This data may be useful to provide improved insight into the histopathology of this organ involvement.
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Affiliation(s)
- M R Alborghetti
- Department of Pathology, Medical School, State University of Campinas (UNICAMP), CEP 13081-970, Campinas-SP, Brazil
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34
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Soares AB, Faria PR, Magna LA, Correa MEP, de Sousa CA, Almeida OP, Cintra ML. Chronic GVHD in minor salivary glands and oral mucosa: histopathological and immunohistochemical evaluation of 25 patients. J Oral Pathol Med 2005; 34:368-73. [PMID: 15946186 DOI: 10.1111/j.1600-0714.2005.00322.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells. METHODS Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining. RESULTS The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands. CONCLUSIONS Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.
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Affiliation(s)
- A B Soares
- Department of Oral Pathology, State University of Campinas, Campinas-SP, Brazil.
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Rossini MS, de Souza EM, Cintra ML, Pagnano KB, Chiari AC, Lorand-Metze I. Cutaneous adverse reaction to 2-chlorodeoxyadenosine with histological flame figures in patients with chronic lymphocytic leukaemia. J Eur Acad Dermatol Venereol 2004; 18:538-42. [PMID: 15324388 DOI: 10.1111/j.1468-3083.2004.00969.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION 2-Chlorodeoxyadenosine (cladribine or 2-CdA) is a purine analogue that has been used successfully in hairy cell leukaemia (HCL). Moreover, it has been increasingly used to treat chronic lymphoproliferative syndromes and paediatric acute myeloid leukaemia. Cutaneous side-effects associated with this drug have seldom been described in cases of HCL. PATIENTS AND METHODS We describe three patients with chronic lymphocytic leukaemia that presented generalized skin eruptions after treatment with 2-CdA. RESULTS All patients had advanced disease, receiving 2-CdA as a second or third line chemotherapy. Skin lesions were severe and chemotherapy had to be discontinued. Histological examination of skin biopsies showed an eosinophil-rich infiltrate with flame figures, similar to what is observed in Wells' syndrome (eosinophilic cellulitis). Corticosteroids were effective to control the eruptions. CONCLUSIONS Cutaneous adverse reactions associated with 2-CdA have seldom been observed in the treatment of HCL. However, as this purine analogue has been used in more advanced cases these may be more frequent and severe. The pathophysiology of these lesions is unclear, but it is probably related to drug-induced change in T-cell imbalance in severely immunosuppressed patients.
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Affiliation(s)
- M S Rossini
- Hematology-Hemotherapy Center, State University of Campinas, Sao Paulo, Brazil
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Abstract
We describe a case of primary aspergillosis involving the tongue of a patient with acute myeloid leukemia. Intraoral aspergillosis is very rare and we found only 23 cases reported in the English literature. Clinically it was a 2-cm, ulcerated, grayish lesion on the dorsum of the tongue. Microscopically there was invasion of the epithelium, connective tissue and muscle of the tongue by fungal hyphae branching at 45 degrees angle. The large hyphae were easily seen by H & E stain, and were strongly positive for periodic acid-Schiff and Grocott methenamine. The patient was successfully treated with intravenous amphotericin B. Based on clinical, microscopic and culture data, the diagnosis of primary aspergillosis of the tongue was established. Invasive oral aspergillosis is a potentially lethal disease and it should be considered in immunosuppressed patients.
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Affiliation(s)
- M E P Correa
- Hematology and Blood Transfusion Center, State University of Campinas, Campinas-SP, Brazil
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Velho PENF, de Moraes AM, Uthida-Tanaka AM, Cintra ML, Gigliogi R. Ultrastructural changes in a standard strain of Bartonella henselae after passages through BALB/cAn mice. Ultrastruct Pathol 2002; 26:161-9. [PMID: 12184374 DOI: 10.1080/01913120290076829] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Human bartonelloses are a group of illnesses of poorly understood pathogenesis. Bartonella henselae is one of the most studied bacterium of its genus. The objective of this study was to observe whether passages of these bacteria, in vivo, would determine ultrastructural changes in them. For this purpose, isogenic mice were inoculated with a standard strain of B. henselae (I). These were initially retrieved from genetically immunodeficient animals (II) and then inoculated in immunocompetent ones. The bacterial colonies obtained (III) were compared, by transmission electron microscopy, with colonies I and II. Loss of fimbriae and an abundant bleb formation were the most common morphological changes found in colony III. Also, on day 6 postinfection, the main histological abnormalities were the endothelial proliferation presented in immunodeficient animals and the incipient granulomata reaction found in one of the immunocompetent inoculated mice, which died spontaneously. These features agree with the Bartonella human disease clinical and histological observations. This study demonstrates that B. henselae in vivo passages induce significant morphological changes in the bacteria and that these abnormalities could explain their seemingly greater virulence. Most of these observations have not been previously described. Thus, further studies on the Bartonella species pathogenesis should consider these data.
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de Lemos ER, Alvarenga FB, Cintra ML, Ramos MC, Paddock CD, Ferebee TL, Zaki SR, Ferreira FC, Ravagnani RC, Machado RD, Guimarães MA, Coura JR. Spotted fever in Brazil: a seroepidemiological study and description of clinical cases in an endemic area in the state of São Paulo. Am J Trop Med Hyg 2001; 65:329-34. [PMID: 11693878 DOI: 10.4269/ajtmh.2001.65.329] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
During 1985-1995, illnesses clinically and epidemiologically compatible with Brazilian spotted fever were identified in 17 patients in the county of Pedreira, in the state of São Paulo, Brazil. Spotted-fever group rickettsial infection was confirmed by serology and/or immunostaining of tissues in 10 of these patients. Immunostaining confirmed infection in a 37-year-old pregnant patient, although rickettsial antigens were not demonstrable in the tissues of the fetus. A serosurvey was conducted in four localities in the county to determine the prevalence of subclinical or asymptomatic infections with spotted fever group rickettsiae. Five hundred and twenty-five blood samples were tested by an indirect immunofluorescence assay for antibodies reactive with Rickettsia rickettsii. Twenty-two (4.2%) of these samples demonstrated titers > or = 1:64. The results indicate that Brazilian spotted fever is endemic within this region of Brazil.
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Affiliation(s)
- E R de Lemos
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
BACKGROUND Silicone gel dressings decrease scar volume and soften hypertrophic tissue, allowing it to be more easily controlled by other methods. Although silicone does not appear to be an essential component of the treatment, nonsilicone dressings have been reported to cause no change in physical parameters during a 2-month treatment period. OBJECTIVE To compare silicone and nonsilicone gel dressings in the treatment of keloids and hypertrophic scars, including a control group, and to evaluate the effectiveness of these treatments using two new assessment techniques. METHODS Patients were randomly chosen to receive silicone or nonsilicone gel dressings in a 4.5-month controlled prospective study. Scar size, induration, and symptoms were evaluated before and after the treatment. Scar color was visually measured using a color palette catalog, and a new device was developed to measure intracicatricial pressure. RESULTS All of the measured parameters were significantly reduced in both silicone- and nonsilicone-treated groups, as compared to the control, with no significant differences between them. CONCLUSION Silicone and nonsilicone gel dressings are equally effective in the treatment of keloids and hypertrophic scars.
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Affiliation(s)
- G V de Oliveira
- Departamento de Pós-graduação em Cirurgia, Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG), and Instituto de Cirurgia Plástica, SOBRAPAR, Campinas, Brazil.
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Souza EM, Cintra ML, Melo VG, Vieira RJ, De Capitani EM, Zambrone FA. Subcutaneous injection of elemental mercury with distant skin lesions. J Toxicol Clin Toxicol 2000; 38:441-3. [PMID: 10930062 DOI: 10.1081/clt-100100955] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mercury poisoning presents a variety of clinical pictures depending on chemical structure, amount absorbed, total mercury burden, and individual factors. Distant skin lesions, after subcutaneous injection of metallic mercury, have not been previously described. CASE REPORT We present a homicidal, subcutaneous injection of mercury resulting in widespread skin lesions, remote from the radiologically visible mercury. The lesions appeared at 40 days and began to clear at 6 months after the injection.
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Affiliation(s)
- E M Souza
- State University of Campinas, São Paulo, Brazil
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41
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de Moraes AM, Cintra ML, Sampaio S de A, Sotto MN, Sesso A. The ultrastructural and histophotometric study of elastic and collagen fibers in type II Ehlers-Danlos syndrome and subclinical forms. Ultrastruct Pathol 2000; 24:129-34. [PMID: 10914423 DOI: 10.1080/01913120050132859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Skin disorders in type II Ehlers-Danlos Syndrome (EDS) are characterized by signs of cutaneous hyperdistensibility, skin and vascular fragility, atrophic scars, and articular hypermobility. These features may have less important clinical presentation in the intermediate forms of type II EDS. The authors studied the ultrastructural and quantitative aspects of elastic and collagen fibers in the skin of individuals with subclinical signs of type II of Ehlers-Danlos Syndrome. A group of 27 individuals (Group I) with large atrophic scars, articular hypermobility of the hands, and cutaneous and vascular fragility were compared with 10 healthy individuals. The subjects from both groups were volunteers from Hospital das Clínicas da Universidade de São Paulo. The elastic fibers did not show alterations but collagen ultrastructural abnormalities were seen in diameter and curvature, such as torsion, collagen flower-like aspect and discrete mass enlargement by histophotometry.
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Affiliation(s)
- A M de Moraes
- Dermatology Division, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), São Paulo, Brazil.
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Abstract
CONTEXT Struma ovarii, a rare neoplasm, is a monophyletic teratoma composed of thyroid tissue. It is generally considered to account for less than 5% of mature teratomas. CASE REPORT A diagnosis of struma ovarii may be the source of many diagnostic problems. It may be cystic and microscopic examination may only reveal a few typical thyroid follicles, resulting in confusion with other cystic ovarian tumors. Extensive sampling should be undertaken and immunohistochemistry may be decisive in establishing the thyroid nature of the epithelial lining. The authors report two cases of cystic struma ovarii, and discuss diagnostic criteria and the limitations of frozen biopsies in these tumors.
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Affiliation(s)
- R B Carvalho
- Departament of Pathology, Medical School, State University of Campinas, Campinas, Brazil
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Giorgio S, Deberaldini ER, Pacheco RS, Pires MQ, Zanotti-Magalhães EM, Cordeiro N, Magalhães LA, Cintra ML, Guimarães NS, Stedile NM. [Cases of american cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis in the towns of Cosmópolis and Indaiatuba-region of Campinas, in São Paulo, Brazil]. Rev Soc Bras Med Trop 1996; 29:419-24. [PMID: 8966306 DOI: 10.1590/s0037-86821996000500003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A study was carried out to identify Leishmania species involved in skin lesions of patients from Cosmópolis and Indaiatuba, State of São Paulo, Brazil. The epidemiological data of cutaneous leishmaniasis in two cities suggested a epidemic situation in 1994. The lesions were clinically characteristic of cutaneous leishmaniasis and five out six patients responded positively to Montenegro's intradermal test. The histopathology of skin lesions were characterized by two patterns: exudative-cellular reaction and exudative granulomatous reaction. The clinical and histopathological parameters suggested Leishmania (Viannia) braziliensis as the possible etiologic agent. In agreement, it was difficult to isolate and maintain the parasite in the laboratory. Characterization by in situ hybridization with kDNA amastigotes from lesions fragments confirmed that Leishmania (Viannia) braziliensis was the parasite responsible for the studied cutaneous lesions.
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Affiliation(s)
- S Giorgio
- Departamento de Parasitologia do Instituto de Biologia e Anatomia Patológica da Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Direção Regional de Saúde XII, Campinas, SP
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Tiziani V, Cintra ML, do Amaral CM, Sabbatini RM, Lima RP. Lack of lymph node reaction to subcutaneously injected silicone gel: histological and computer aided morphometric study in rats. Scand J Plast Reconstr Surg Hand Surg 1995; 29:303-11. [PMID: 8771256 DOI: 10.3109/02844319509008964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The gel of silicone implants may bleed through the elastomeric envelope or may come into contact with the body because of rupture of the implant. We have studied the effects of free silicone gel injected into the subcutaneous space in rats and analysed the morphological features of the axillary and inguinal lymph nodes. Ninety six Wistar rats had 3 cm3 of silicone gel injected into their subcutaneous space and 96 Wistar rats (the control group) had distilled water injected into their subcutaneous space. The animals were killed on days 1,3,7,9,15, 30,60,90,120,180,270, and 365 after the injection. There was no detectable silicone and no damage to the lymph nodes on routine histopathological analysis. Small amounts of silicone that could migrate to lymph nodes could result in hyperplasia. To evaluate this possibility, a morphometric study based on a computer aided system compared the area of lymph node sections between treated and control animals, and showed no difference between treated and control groups. If silicone did migrate, it did not provoke morphological signs or hyperplasia in the lymph nodes.
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Affiliation(s)
- V Tiziani
- Department of Pathology, School of Medicine, State University of Campinas (UNICAMP), Brazil
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Rabinowitz LG, Cintra ML, Hood AF, Esterly NB. Recurrent palmoplantar hidradenitis in children. Arch Dermatol 1995; 131:817-820. [PMID: 7611798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND There are several reports of tender, erythematous plantar nodules occurring in pediatric patients. Despite similar morphological features, the histologic findings in these lesions have been quite diverse. A new entity called idiopathic plantar hidradenitis (also termed neutrophilic eccrine hidradenitis in children), which is characterized by tender, red nodules on the feet and unique histopathologic features, was recently described. OBSERVATIONS We describe two children with these unusual cutaneous lesions and histopathologic findings and compare them with patients with idiopathic plantar hidradenitis. Our patients, in contrast to those with idiopathic plantar hidradenitis, had involvement of the palms as well as the soles. Both children had self-limited recurrent lesions; in one child, the lesions were associated with low-grade fever. Biopsy specimen findings in both cases demonstrated dense neutrophilic infiltrates localized to the eccrine units. CONCLUSIONS Our patients had clinical and histologic findings similar to those recently reported as idiopathic plantar hidradenitis (neutrophilic eccrine hidradenitis in children). Because palms and soles can be affected and the lesions typically recur, we suggest that this condition be referred to as recurrent palmoplantar hidradenitis.
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Affiliation(s)
- L G Rabinowitz
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA
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Abstract
A histopathological study of a distinct papule isolated from a patient's neck is reported and compared to 80 melanocytic nevi. The histogenesis of this unique tumor indicates that it probably represents the residual of a melanocytic nevus in which nevi cells have disappeared but fat infiltration and fibrosis of the dermis and the typical aspects of other cutaneous elements persisted. The finding of focal acantholytic dyskeratosis in multiple foci of the lesion may indicate melanocytic cells regression. Lesions with the histopathological appearance of melanocytic nevi, even in the absence of nevi cells, may be discovered scrutinizing the associated alterations.
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Affiliation(s)
- M L Cintra
- Department of Pathology, UNICAMP, Campinas, SP, Brazil
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do Amaral CM, Tiziani V, Cintra ML, Amstalden I, Palhares FB. Local reaction and migration of injected silicone gel: experimental study. Aesthetic Plast Surg 1993; 17:335-8. [PMID: 8273537 DOI: 10.1007/bf00437108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A study of the local and migratory effects of free silicone gel taken from a mammary prosthesis is reported. Thirty eight Wistar rats were injected in their subcutaneous space with 1 cm3 of silicone gel. The animals were sacrificed on day: 3, 7, 15, 30, 60, 180, 240, 360, 420, 450. The visceral organs (heart, kidneys, lungs, stomach, gonads, liver, pancreas, spleen, intestine), as well as the tissue adjacent to the region of injection, were histologically analyzed. There was no detectable silicone and no damage to the visceral organs based on routine histopathological analysis. The greatest fibrosis was observed at the extremities of the disk formed by the silicone in the subcutaneous space.
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Cintra ML, de Souza EM. Focal acantholytic dyskeratosis: a snare for the pathologist. Report of two cases associated to psoriasis and fibrous papule of the nose. Rev Paul Med 1992; 110:237-40. [PMID: 1341018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Two specimens containing clinically inapparent histologic features of acantholytic dyskeratosis (on the base of a fibrous papule of the nose and overlying a psoriatic lesion) are presented. The authors discuss the conduct to be followed by the pathologist in similar cases. The general pathologist should be well trained in dermatopathology since cutaneous biopsies account for 10 to 25% of the specimens submitted for histologic diagnosis or, even, form the major part of the workload (Berry). There is a wall between the physician who submits the skin biopsies (who may be or not a dermatologist) and the pathologist. The clinical information provided by dermatologists is scant and incomplete and physicians who are not dermatologists seldom submit any information. The histological pictures found in skin biopsies are, often, common to several nosological entities and an adequate understanding of their meaning is desirable for a thorough evaluation. We ought to assess it with the maximum scientific severity, searching to solve the puzzle without depreciating the information received. In this report the authors analyse the histopathological approach to the cutaneous lesions of two patients. They displayed the association between acantholytic dyskeratosis (AD) and another cutaneous pathology. Findings like these may obstruct the final diagnosis to be issued by the pathologist.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M L Cintra
- Department of Pathology and Dermatology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, UNICAMP, São Paulo, Brasil
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Cintra ML, Billis A. Histologic grading of prostatic adenocarcinoma: intraobserver reproducibility of the Mostofi, Gleason and Böcking grading systems. Int Urol Nephrol 1991; 23:449-54. [PMID: 1938244 DOI: 10.1007/bf02583988] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Intraobserver variation of three grading systems--Mostofi, Gleason and Böcking--is examined. No significant difference was noted between the histological grades found in the two examinations by any of the three methods used. Neither the type of surgical procedure nor the number of slices with tumour influenced the reproducibility of histological grading within each system studied. In the Gleason system the intraobserver highest disagreement would not have resulted in change of therapy choice, but in 2% of tumours graded according to the Mostofi system this would have occurred if the choice of therapy would depend on the grading results.
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Affiliation(s)
- M L Cintra
- Departamento de Anatomia Patológica, Universidade Estadual de Campinas, Brazil
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