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Cavalcante RBDM, Valente NYS, Ferreira PS, Neto CF, Torezan L. Assessment of reflectance confocal microscopy for monitoring treatment of actinic keratosis and field cancerization with daylight photodynamic therapy. Eur J Dermatol 2023; 33:674-679. [PMID: 38465549 DOI: 10.1684/ejd.2023.4579] [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] [Indexed: 03/12/2024]
Abstract
Actinic keratosis (AK) is the most common pre-malignant cutaneous lesion of the skin, often associated with field cancerization. Daylight photodynamic therapy (DL-PDT) is used as treatment, showing good histological results. Reflectance confocal microscopy (RCM) may be useful as a non-invasive, real-time approach to monitor treatment, however, there is a lack of data on the correlation between RCM and histopathological findings in AK patients treated with DL-PDT. To correlate histological and RCM findings and evaluate the efficacy of DL-PDT in patients with AK and field cancerization treated with DL-PDT. Patients with field cancerization and a minimum of six AK lesions on the face were included in the study. A single session combining methyl aminolevulinate followed by two-hour daylight exposure of the face was performed. RCM and biopsy were performed before and after three months of the intervention to compare efficacy between patients using the Wilcoxon test, and concordance of the findings based on the different methods was analysed using the Kappa test. Twenty-four patients completed the study. An improvement in photodamage and a decrease in the number of AK lesions (45.3% reduction) was observed. Regression in atypia and dysplasia was observed via histopathology and RCM, however, there was poor agreement between the methods. No changes were observed after treatment for inflammation, fibroplasia and acantholysis. Concordance between histological and RCM findings was poor, suggesting that RCM cannot replace the histopathological examination, however, it may be used as an adjuvant test for follow-up of patients. Despite this, DL-PDT proved to be an effective method for treating AK.
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Affiliation(s)
| | | | | | - Cyro Festa Neto
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | - Luis Torezan
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
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Rocha LKFL, Ferreira P, Gianotti MA, Avancini J, Menck CFM, Castro LP, de Oliveira ZNP, Rivitti MC, Samorano LP, Pereira NV, Festa Neto C. Imiquimod chemoprophylaxis for field cancerization in xeroderma pigmentosum patients-A prospective study. Australas J Dermatol 2023; 64:435-438. [PMID: 37052254 DOI: 10.1111/ajd.14029] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/10/2023] [Accepted: 03/22/2023] [Indexed: 04/14/2023]
Affiliation(s)
| | - Paula Ferreira
- Hospital das Clínicas of São Paulo University, São Paulo, Brazil
| | | | - João Avancini
- Hospital das Clínicas of São Paulo University, São Paulo, Brazil
| | - Carlos F M Menck
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ligia P Castro
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Maria C Rivitti
- Hospital das Clínicas of São Paulo University, São Paulo, Brazil
| | | | - Naiura Vieira Pereira
- Laboratory of Dermatologia Tropical, Hospital das Clínicas of São Paulo University, São Paulo, Brazil
| | - Cyro Festa Neto
- Department of Dermatology, Hospital das Clínicas of São Paulo University, São Paulo, Brazil
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Miotto IZ, Neto CF, de Oliveira WRP. Cutaneous infections from viral sources in solid organ transplant recipients. Transpl Immunol 2023; 78:101838. [PMID: 37085124 DOI: 10.1016/j.trim.2023.101838] [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: 12/22/2022] [Revised: 04/16/2023] [Accepted: 04/16/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Solid organ transplant recipients (SOTRs) are susceptible to various dermatological complications caused by long-term immunosuppressive therapy. Of these complications, viral infections are noteworthy because of their high prevalence and the potential morbidity associated with viral carcinogenesis. OBJECTIVES To evaluate the occurrence of cutaneous viral infections in SOTRs and their correlation with clinical features, transplant type, and the length and intensity of immunosuppressive therapy. METHODS This retrospective cohort study included SOTRs followed up at the Department of Dermatology in a tertiary hospital. The outcomes analyzed were the occurrence of cutaneous viral infections, including human papillomavirus (HPV) infection, herpes simplex, herpes zoster, molluscum contagiosum, Merkel cell carcinoma, Kaposi's sarcoma, and cytomegalovirus, and the occurrence of HPV-related neoplasms. Clinical variables, such as length and intensity of immunosuppression, type of transplanted organ, and comorbidities, were analyzed as possible risk factors for cutaneous viral infections in SOTRs. RESULTS A total of 528 SOTRs were included in this study, among which 53.8% had one or more viral infections. Of these, 10% developed a virus-associated malignancy (HPV-associated carcinoma, Merkel cell carcinoma, or Kaposi's sarcoma). The higher risk of viral infections among SOTRs was associated with cyclosporine intake (1.40-fold higher risk) and younger age at transplantation. The use of an immunosuppressive regimen, including additional drugs, was associated with a higher risk of genital HPV infection (1.50-fold higher risk for each incremental drug). CONCLUSIONS The occurrence of cutaneous viral infections in SOTRs is directly associated with the duration and intensity of immunosuppressive therapy. Patients at higher risk were those taking drugs with a stronger impact on cellular immunity and/or those on an immunosuppressive regimen comprising various drugs.
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Affiliation(s)
- Isadora Zago Miotto
- Department of Dermatology, University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar, 255, Zip Code, 05403-900, São Paulo, Brazil.
| | - Cyro Festa Neto
- Department of Dermatology, University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar, 255, Zip Code, 05403-900, São Paulo, Brazil
| | - Walmar Roncalli Pereira de Oliveira
- Department of Dermatology, University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar, 255, Zip Code, 05403-900, São Paulo, Brazil.
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Bianchi MG, Sotto M, Giavina-Bianchi P, Festa Neto C, Duncan LM, Kalil J. 18509 Nodular primary cutaneous melanoma is associated with PD-L1 expression. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.492] [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: 11/17/2022]
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Giavina-Bianchi M, Nacagamo Sotto M, Giavina-Bianchi P, Munhoz R, Festa Neto C, Kalil J. Inter- and intra-patient heterogeneity of PD-L1 expression in metastatic melanomas: A retrospective study. Australas J Dermatol 2020; 62:227-229. [PMID: 33216949 DOI: 10.1111/ajd.13498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Mara Giavina-Bianchi
- Dermatology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Clinical Immunology and Allergy Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mirian Nacagamo Sotto
- Dermatology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Pedro Giavina-Bianchi
- Clinical Immunology and Allergy Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo Munhoz
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Cyro Festa Neto
- Dermatology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jorge Kalil
- Clinical Immunology and Allergy Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Giavina-Bianchi M, Giavina-Bianchi P, Sotto MN, Rodig S, Mihm M, Festa Neto C, Duncan LM, Kalil J. Nodular primary cutaneous melanoma is associated with PD-L1 expression. Eur J Dermatol 2020; 30:352-357. [PMID: 32969795 DOI: 10.1684/ejd.2020.3846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND In previous studies, patients with Stage III melanomas expressing PD-L1 in more than 5% of their neoplastic cells had improved recurrence-free survival with anti-PD1 adjuvant therapy. OBJECTIVES We examined PD-L1 expression as a possible biomarker of primary cutaneous melanomas in the vertical growth phase. MATERIALS AND METHODS This was a retrospective study including 66 patients with invasive primary cutaneous melanomas. We assessed patient clinical and histopathological data and performed immunohistochemical assays with melanoma specimens from the patients to evaluate PD-L1, PD-1, CD3, CD8 and FoxP3 expression. RESULTS We observed PD-L1 expression in 21% (14/66) of our samples, and this expression correlated with increased melanoma thickness (p = 0.002) and nodular-type melanoma (p = 0.001). After adjusting for tumor thickness using a logistic regression test, the association of PD-L1 with nodular-type melanoma persisted. Nodular-type melanoma was 6.48 times more likely to be positive for PD-L1 than other histological types (p = 0.014; 95% CI: 1.46-28.82). As expected, PD-L1 expression correlated with the number of PD-1-expressing cells in the tumor-infiltrating lymphocyte population (p = 0.04). No correlation with PD-L1 was observed for age, sex, tumor site, skin phototype, ulceration status, sentinel lymph node status, metastasis development or survival. Regarding the immune profile of the tumor-infiltrating lymphocytes of PD-L1-positive and -negative groups, no significant differences were observed in the numbers of CD3 + , CD8 + FoxP3-, CD8-FoxP3+ and CD8 + FoxP3+ cells by immunohistochemistry. CONCLUSION Nodular-type melanoma is associated with PD-L1 expression and may be a suitable candidate for adjuvant therapy of primary melanomas treated with immunotherapy.
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Affiliation(s)
- Mara Giavina-Bianchi
- Department of Dermatology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 3 andar, 05403-900, São Paulo SP, Brazil, Division of Clinical Immunology and Allergy, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 8 andar, 05403-900, São Paulo SP, Brazil
| | - Pedro Giavina-Bianchi
- Division of Clinical Immunology and Allergy, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 8 andar, 05403-900, São Paulo SP, Brazil
| | - Mirian Nacagamo Sotto
- Department of Dermatology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 3 andar, 05403-900, São Paulo SP, Brazil
| | - Scott Rodig
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 15 Shattuck Street, Boston MA, 02115, USA
| | - Martin Mihm
- Mihm Cutaneous Pathology Consultative Service, Emmanuel College, 41 Louis Pasteur Street, Room 360, Boston MA, 02115, USA
| | - Cyro Festa Neto
- Department of Dermatology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 3 andar, 05403-900, São Paulo SP, Brazil
| | - Lyn M Duncan
- Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Harvard Medical School, Warren Building 825, 55 Fruit Street, Boston MA 02114, USA
| | - Jorge Kalil
- Division of Clinical Immunology and Allergy, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 8 andar, 05403-900, São Paulo SP, Brazil
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Neto CF, Santos GC, Santos MJMC. Influence of the Fabrication Technique on the Marginal and Internal Adaptation of Ceramic Onlays. Oper Dent 2020; 45:163-172. [DOI: 10.2341/19-014-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This study aimed to evaluate the marginal and internal adaptation of partial coverage crowns (ceramic onlays) fabricated with Press, CEREC BlueCam, and CEREC OmniCam systems, using two preparation designs and evaluating the internal discrepancies at different locations. Two phantom maxillary premolars (master teeth) received different preparation designs, with (BX) and without (NB) a modified occlusal box with round internal angles. Sixty IPS e-max ceramic restorations were fabricated with three systems: Press (n=20), CEREC BlueCam (n=20), and CEREC OmniCam (n=20). Both marginal and internal discrepancy width were measured by using a stereomicroscope at ×25 magnification. The data were evaluated statistically using analysis of variance followed by Tukey's Honestly Significant Difference test (α=0.05). The ceramic restorations fabricated with the Press system presented significantly smaller marginal and internal disadaptations than the BlueCam and OmniCam CEREC systems (p<0.0001). Regarding the preparation designs, preparation BX presented the smallest marginal discrepancies for all fabrication systems and larger internal discrepancies than for restorations fabricated with the Press system. The occlusal location presented a larger internal discrepancy compared with the axial locations. Although the three systems resulted in the fabrication of restorations within a clinically acceptable adaptation with marginal discrepancies below 100 μm, the Press system presented the smallest marginal and internal discrepancies. An improved marginal adaptation was observed in the preparation design with a modified occlusal box with rounded internal angles.
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Affiliation(s)
- CF Neto
- Constantino Fernandes Neto, DDS, MSc candidate, Bauru Dental School, Universidade de São Paulo, Bauru SP, Brazil
| | - GC Santos
- Gildo Coelho Santos, DDS, MSc, PhD, associate professor, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - MJMC Santos
- Gildo Coelho Santos, DDS, MSc, PhD, associate professor, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Miyashiro D, Torezan LA, Grinblat BM, Festa Neto C. Novel mutation in PTCH1 gene in a patient with basal cell nevus syndrome and uterus bicornis. An Bras Dermatol 2019; 94:487-489. [PMID: 31644632 PMCID: PMC7007026 DOI: 10.1590/abd1806-4841.20197449] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/13/2018] [Indexed: 11/21/2022] Open
Affiliation(s)
- Denis Miyashiro
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luis Antonio Torezan
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Beni Moreinas Grinblat
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Cyro Festa Neto
- Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Neto CF, Oliveira WRP, Costa PVA, Cardoso MK, Barreto PG, Romano CM, Urbano PR. The first observation of the association of Merkel cell polyomavirus and Merkel cell carcinoma in Brazil. Int J Dermatol 2019; 58:703-706. [DOI: 10.1111/ijd.14325] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 07/05/2018] [Revised: 09/28/2018] [Accepted: 11/14/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Cyro Festa Neto
- Department of Dermatology Clinics Hospital of the Medical School University of São Paulo São Paulo Brazil
| | - Walmar R. P. Oliveira
- Department of Dermatology Clinics Hospital of the Medical School University of São Paulo São Paulo Brazil
| | - Pedro V. A. Costa
- Department of Dermatology Clinics Hospital of the Medical School University of São Paulo São Paulo Brazil
| | - Melina K. Cardoso
- Department of Dermatology Clinics Hospital of the Medical School University of São Paulo São Paulo Brazil
| | - Paula G. Barreto
- Department of Dermatology Clinics Hospital of the Medical School University of São Paulo São Paulo Brazil
| | - Camila M. Romano
- Virology Medical Research Laboratory Institute of Tropical Medicine University of São Paulo São Paulo Brazil
| | - Paulo R. Urbano
- Virology Medical Research Laboratory Institute of Tropical Medicine University of São Paulo São Paulo Brazil
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Oliveira WRP, Tirico MCCP, Souza AAV, Codarin FR, Silva LLC, Festa Neto C. Skin lesions in organ transplant recipients: a study of 177 consecutive Brazilian patients. Int J Dermatol 2018; 58:440-448. [PMID: 30565651 DOI: 10.1111/ijd.14285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/21/2018] [Accepted: 10/08/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Skin lesions are very common among organ transplant recipients (OTR), particularly infections and tumors, because of the immunosuppressive state these patients are put in. METHODS 177 OTR were examined. Skin lesions were categorized into neoplastic, infectious, and inflammatory diseases. RESULTS The mean age of OTR was 52 years, the mean age at transplantation was 42.7 years, and kidney was the most common organ transplanted (72%). Skin lesions were found in 147 patients (83%). Cutaneous infections were seen in 106 patients (60%). Warts (30%) had the larger incidence and were associated with azathioprine (P = 0.026), cyclosporine (P = 0.006), and tacrolimus (P = 0.009). Superficial mycoses occurred in 16% of OTR, mostly onychomycosis, which was associated with tacrolimus (P = 0.040). Actinic keratosis (AK) occurred in 31% of patients and cutaneous tumors in 56%. Squamous cell carcinoma (SCC) was the most common tumor type affecting 36% of OTR (n = 64), with invasive SCC predominating over in situ SCC, whereas basal cell carcinoma (BCC) accounted for 17%. Both SCC and BCC were more numerous in patients' skin type I (P < 0.05). SCC was more frequent (36%) in combined kidney and liver recipients (P = 0.004), and BCC was associated with cyclosporine (P = 0.047). Inflammatory complications (acne, alopecia, hypertrichosis, and gingival overgrowth) were observed in 17.5% of patients. CONCLUSIONS Organ transplant recipients must be regularly evaluated by dermatologists, who should be alert to the onset of infections and skin (pre)malignant diseases in these patients.
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Affiliation(s)
- Walmar R P Oliveira
- Department of Dermatology, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Maria C C P Tirico
- Department of Dermatology, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Anaisa A V Souza
- Department of Dermatology, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Felipe R Codarin
- Department of Dermatology, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Lana L C Silva
- Department of Dermatology, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Sao Paulo, Brazil
| | - Cyro Festa Neto
- Department of Dermatology, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, Sao Paulo, Brazil
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Gavioli CFB, Festa Neto C, Tyring SK, Silva LLDC, de Oliveira WRP. High-risk mucosal HPV types associated with squamous cell carcinoma on the nose tip in an immunocompetent young man. An Bras Dermatol 2018; 93:716-718. [PMID: 30156623 PMCID: PMC6106684 DOI: 10.1590/abd1806-4841.20186919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 10/01/2017] [Indexed: 11/22/2022] Open
Abstract
The oncogenic role of high-risk HPV in anogenital, head and neck, and cervical cancer is well recognized, but not in skin cancer in the general population. Some authors have demonstrated their appearance mainly on the hands and feet, particularly in the area of the nail bed, which could be due to contamination with HPV types from anogenital regions. Here, we describe a case of genital HPV associated with SCC on the nose tip in an immunocompetent young man, which was confirmed by histopathological findings and in situ hybridization. The importance of this report is to highlight the potential role of HPV in the etiology of skin cancer in an immunocompetent individual.
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Affiliation(s)
| | - Cyro Festa Neto
- Department of Dermatology, Faculdade de Medicina, Universidade de
São Paulo, São Paulo (SP), Brazil
| | - Stephen K Tyring
- Department of Dermatology, University of Texas Health Science
Center, Houston, United States of America
| | - Lana Luiza da Cruz Silva
- Department of Dermatology, Faculdade de Medicina, Universidade de
São Paulo, São Paulo (SP), Brazil
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Victo NCD, Adjemian S, Nunes RDSS, Volpini RA, Giavina-Bianchi MH, Neto CF, Câmara NOS, Amarante-Mendes GP, Jacysyn JDF. Abstract B59: Role of Dicer on human melanoma progression and resistance. Clin Cancer Res 2018. [DOI: 10.1158/1557-3265.tcm17-b59] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Melanoma is a serious public health problem that affects the population of Latin America and is increasing rapidly compared to other types of tumors. The growth or change in this type of tumor is progressive and is in the horizontal and/or vertical direction. Breslow thickness (vertical staging) is the tumor thickness in the dermis where patients with lesion thickness less than 0.75 mm have good prognosis, unlike lesion thickness larger than 3 mm. This stage is classified into T (primary tumor): T0 (with no evidence of primary tumor); Tis (in situ melanoma); T1 (1 mm); T2 (1.01 to 2 mm); T3 (2.01 to 4 mm); and T4 (above 4 mm). Knowing some molecular markers of melanoma is essential for the identification of genetically predisposed individuals, as well as early detection of the disease. Recent works has demonstrated that microRNAs may be involved in modulation of melanoma. Dicer is an essential member of the RNase III family which controls maturation of miRNAs in the cytoplasm from microRNA precursors (pre-miRNAs). The upregulation of Dicer is associated with aggressive features and proliferation of melanoma and no other skin tumors such as carcinomas and sarcoma. In our present study, we found that the knockdown expression of Dicer using the CRISPR/CAS9 in melanoma cell line induced more chemosensitivity to cisplatin and these changes correlated with the downregulation of Dicer. We examined the consequence of Dicer knockdown on melanoma cell proliferation, clonogenic assays, and overall survival. We also compared Dicer in tissue from patients diagnosed with melanoma in different stages with the prognosis of these patients, suggesting that the reduction in Dicer expression is associated with melanoma progression. Considering the fundamental and multiple biologic roles of Dicer in various cellular processes, our results suggest that modulation of Dicer in melanoma should become a promising therapeutic candidate for further clinical application.
Note: This abstract was not presented at the conference.
Citation Format: Nathalia Cruz de Victo, Sandy Adjemian, Romulo dos Santos Sobreira Nunes, Rildo Aparecido Volpini, Mara Huffenbaecher Giavina-Bianchi, Cyro Festa Neto, Niels Olsen Saraiva Câmara, Gustavo Pessini Amarante-Mendes, Jacqueline de Fátima Jacysyn. Role of Dicer on human melanoma progression and resistance [abstract]. In: Proceedings of the AACR International Conference held in cooperation with the Latin American Cooperative Oncology Group (LACOG) on Translational Cancer Medicine; May 4-6, 2017; São Paulo, Brazil. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(1_Suppl):Abstract nr B59.
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Affiliation(s)
- Nathalia Cruz de Victo
- 1Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil,
| | - Sandy Adjemian
- 2Inflammation Research Center, VIB, UGent, Gent, Belgium,
| | | | - Rildo Aparecido Volpini
- 4Laboratory of Basic Research in Renal Diseases LIM12, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil,
| | | | - Cyro Festa Neto
- 5Department of Dermatology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Niels Olsen Saraiva Câmara
- 1Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil,
| | | | - Jacqueline de Fátima Jacysyn
- 3Laboratory of Surgical Pathophysiology LIM62, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil,
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Canuto MJ, Martins ACGP, Dwan AJ, Neto CF, Simonsen Nico MM. Extraordinary Findings in a Case of Self-inflicted Cutaneous Lesions. Acta Derm Venereol 2017; 97:967-968. [PMID: 28421228 DOI: 10.2340/00015555-2680] [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: 11/16/2022] Open
Affiliation(s)
- Maria Julia Canuto
- Department of Dermatology, Medical School, University of São Paulo, São Paulo, Brazil
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Chaves YN, Torezan LA, Lourenço SV, Neto CF. Evaluation of the efficacy of photodynamic therapy for the treatment of actinic cheilitis. Photodermatol Photoimmunol Photomed 2017; 33:14-21. [PMID: 27864997 DOI: 10.1111/phpp.12281] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/10/2016] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Actinic cheilitis (AC) is a lip intraepithelial neoplasia, whose cells present alterations similar to those presented by invasive squamous cell carcinomas (SCCs). OBJECTIVE To conduct clinical and laboratory evaluation by histopathology and immunohistochemistry of the efficacy of actinic cheilitis treatment using photodynamic therapy (PDT) with methyl aminolevulinate (MAL) and noncoherent red light. MATERIALS AND METHODS Patients with actinic cheilitis detected by histopathological examination were submitted to two sessions of photodynamic therapy with a two-week interval between them. They were examined immediately after the sessions, four, six, and twelve weeks after beginning treatment when a new biopsy was carried out. Clinical histopathological and immunohistochemical parameters were evaluated before and after treatment. RESULTS Of the 23 patients who underwent biopsy, 16 completed two photodynamic therapy sessions and the material of one patient was insufficient for immunohistochemistry. Complete clinical response was achieved in 62.5% (10 of 16 patients) and 37.5% still remained with clinical evidence of AC. In spite of this, no case of cure by histopathological analysis was found. There was no significant statistical change among the values of Ki-67, survivin, and p53 observed before and after treatment. CONCLUSION Photodynamic therapy, as carried out in this trial, was not an efficacious therapeutic option for treating patients with actinic cheilitis included in this sample.
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Affiliation(s)
- Yuri N Chaves
- Department of Dermatology, Faculdade de Medicina Hospital das Clinicas, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Luis Antonio Torezan
- Department of Dermatology, Faculdade de Medicina Hospital das Clinicas, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Silvia Vanessa Lourenço
- Department of Dermatology, Faculdade de Medicina Hospital das Clinicas, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Cyro Festa Neto
- Department of Dermatology, Faculdade de Medicina Hospital das Clinicas, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Abstract
In the recent past years, many discoveries in the tumor microenvironment have led to changes in the management of melanoma and it is rising up hopes, specially, to those in advanced stages. FDA approved seven new drugs from 2011 to 2014. They are: Vemurafenib, Dabrafenib and Trametinib, kinases inhibitors used for patients that have BRAFV600E mutation; Ipilimumab (anti-CTLA4), Pembrolizumab (anti-PD-1) and Nivolumab (anti-PD-1), monoclonal antibodies that stimulate the immune system; and Peginterferon alfa-2b, an anti-proliferative cytokine used as adjuvant therapy. In this article, we will review the molecular bases for these new metastatic melanoma therapeutic agents cited above and also analyze new molecular discoveries in melanoma study, as Cancer-Testis antigens (CT). They are capable of induce humoral and cellular immune responses in cancer patients and because of this immunogenicity and their restrict expression in normal tissues, they are considered an ideal candidate for vaccine development against cancer. Among CT antigens, NY-ESO-1 is the best characterized in terms of expression patterns and immunogenicity. It is expressed in 20-40% of all melanomas, more in metastatic lesions than in primary ones, and it is very heterogeneous inter and intratumoral. Breslow index is associate with NY-ESO-1 expression in primary cutaneous melanomas, but its relation to patient survival remains controversial.
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Affiliation(s)
| | | | - Cyro Festa Neto
- Dermatology Department of Universidade de São Paulo Medical
School (FMUSP) – São Paulo (SP), Brazil
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16
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Casarin Costa JR, Virgens AR, de Oliveira Mestre L, Dias NF, Samorano LP, Valente NYS, Festa Neto C. Sweet Syndrome: Clinical Features, Histopathology, and Associations of 83 Cases. J Cutan Med Surg 2017; 21:211-216. [PMID: 28300447 DOI: 10.1177/1203475417690719] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Sweet syndrome (SS) is an infrequent skin disease characterised by sudden onset of fever, leukocytosis, neutrophilia, and tender erythematous plaques infiltrated by neutrophils. Multiple conditions have been associated with this syndrome. OBJECTIVES The aim of this study was to evaluate the clinical, epidemiological, laboratory, and histopathological findings and associations of patients with SS. METHODS We conducted a retrospective study of 83 patients with SS followed between January 1, 2006, and January 31, 2015. RESULTS Of the patients, 82% were female; the mean age at onset was 48 years. Clinical presentation was mainly characterised by erythematous and edematous plaques, mostly on upper extremities and trunk. Fever was observed in 32%; 60% presented leukocytosis and 39% neutrophilia. On histopathological examination, neutrophilic and lymphohistiocytic infiltrate and edema were the most frequent findings. Fourteen percent of patients had malignancy or hematologic disorders, 26% were classified as having drug-induced SS, and 24% noted recent infection. Only 2 cases occurred during pregnancy. Systemic corticosteroid was the most common choice of treatment, with excellent response. In malignancy-associated SS, the mean hemoglobin level was lower ( P = .01) and the erythrocyte sedimentation rate (ESR) was higher ( P = .04) in comparison to classic and drug-induced SS. Leukocytoclasia was associated with higher risk of recurrence ( P = .01). CONCLUSION All patients with SS deserve careful investigation of possible underlying conditions. Higher ESR and lower hemoglobin levels might reinforce the need of malignancy screening. Also, leukocytoclasia appears to be a potential marker of higher recurrence rate, demanding closer and longer follow-up.
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Affiliation(s)
- Jose Ricardo Casarin Costa
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
| | - Anangelica Rodrigues Virgens
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
| | - Luisa de Oliveira Mestre
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
| | - Natasha Favoretto Dias
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
| | - Luciana Paula Samorano
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
| | - Neusa Yuriko Sakai Valente
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
| | - Cyro Festa Neto
- 1 Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, SP, Brazil
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de Oliveira WRP, Borsato MFL, Dabronzo MLD, Festa Neto C, Rocha LA, Nunes RS. Phaeohyphomycosis in renal transplantation: report of two cases. An Bras Dermatol 2016; 91:89-92. [PMID: 26982786 PMCID: PMC4782654 DOI: 10.1590/abd1806-4841.20163954] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 10/09/2014] [Indexed: 11/22/2022] Open
Abstract
Phaeohyphomycosis is an infection caused by a filamentous fungus that contains
pigment melanin in its cell wall. We report two cases caused by Exophiala sp.
emphasizing the clinical variability of the disease, as well as diagnostic and
therapeutic difficulties of this opportunistic infection in immunosuppressed
patients (kidney transplant).
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da Silva WC, Oshiro TM, de Sá DC, Franco DDGS, Festa Neto C, Pontillo A. Genotyping and differential expression analysis of inflammasome genes in sporadic malignant melanoma reveal novel contribution of CARD8, IL1B and IL18 in melanoma susceptibility and progression. Cancer Genet 2016; 209:474-480. [PMID: 27810076 DOI: 10.1016/j.cancergen.2016.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 05/24/2016] [Revised: 08/30/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
Abstract
Sporadic melanoma malignancy is correlated with constitutive secretion of IL-1β in transformed melanocytes suggesting the involvement of inflammasome in melanoma. Common variants in inflammasome genes are known to affect IL-1β expression. To investigate the contribution of inflammasome genetics in melanoma development and progression and to identify a potential prognostic marker, the distribution of selected inflammasome SNPs was analysed in a Brazilian case/control cohort of sporadic malignant melanoma (SMM) and then the expression of inflammasome components was evaluated in melanoma biopsies. Allele and gene-specific Taqman assays were implied for genotyping of case/control DNA samples and for relative expression analysis in skin biopsies respectively. CARD8 rs6509365 was found to be significantly more common in healthy volunteers than in SMM patients suggesting a protection effect of this variant towards melanoma development. Accordingly, CARD8 expression was found to be reduced in nevus compared to melanoma biopsies. Upon stratification, NLRP1 rs11651270 and CARD8 rs2043211 were found associated with nodular melanoma; IL1B rs1143643 to a lower value of Breslow index; IL18 rs5744256 to melanoma development in sun sensitive individuals. As expected, IL1B expression was up-regulated in tumour biopsies especially in metastatic samples, whereas IL18 was down-regulated compared to nevus. Our results demonstrated for the first time the contribution of inflammasome genes CARD8, IL1B and IL18 in SMM.
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Affiliation(s)
- Wanessa Cardoso da Silva
- Laboratory of Medical Investigation in Dermatology and Immunodeficiences-LIM 56, Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Avenida Dr Eneas de Carvalho Aguiar, 470 - Prédio 2-3° andar, 05403-000 Cerqueira César, Sao Paulo, Brazil.
| | - Telma Miyuki Oshiro
- Laboratory of Medical Investigation in Dermatology and Immunodeficiences-LIM 56, Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Avenida Dr Eneas de Carvalho Aguiar, 470 - Prédio 2-3° andar, 05403-000 Cerqueira César, Sao Paulo, Brazil
| | - Daniel Coelho de Sá
- Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar 500, 05403-000 Cerqueira Cesar, Sao Paulo, Brazil
| | - Dilcilea D G S Franco
- Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar 500, 05403-000 Cerqueira Cesar, Sao Paulo, Brazil
| | - Cyro Festa Neto
- Department of Dermatology, Faculty of Medicine, University of Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar 500, 05403-000 Cerqueira Cesar, Sao Paulo, Brazil
| | - Alessandra Pontillo
- Laboratory of Immunogenetics, Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, Avenida Prof. Lineu Prestes 1730, 05508-000 Cidade Universitaria, Sao Paulo, Brazil
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de Oliveira WRP, He Q, Rady PL, Hughes TK, Neto CF, Rivitti EA, Tyring SK. HPV Typing in Brazilian Patients witn Epidermodysplasia Verruciformis: High Prevalence of EV-HPV 25. J Cutan Med Surg 2016. [DOI: 10.1177/120347540400800206] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Epidermodysplasia verruciformis is a rare genetic disorder characterized by development of lesions associated with HPV#5 or HPV#8 in early childhood; malignant transformation occurs in approximately half of individuals during adulthood. Objective: Our goal was to study the presence and spectrum of EV-HPV types in Brazilian EV patients, a population that had never been studied in this regard. Patients and MethodsForty-one biopsies from different lesions (benign and skin tumors) and one biopsy from clinically normal skin from each of 20 Brazilian patients with EV were studied for HPV typing using nested PCR. Results: EV-HPV DNA was detected in all 41 skin lesions of the patients and was also identified in specimens considered as normal skin from 8 patients (40%). In this study HPV-EV 25 was the most prevalent (70%), and HPV 14d (67%) was highly associated with malignant lesions. Conclusion: EV-HPV 25 was the most prevalent in our study. The noteworthy association of EV-HPV type 14d with skin cancers suggests its possible oncogenic role in malignant transformation in this population.
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Affiliation(s)
- Walmar Roncalli P. de Oliveira
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
- Department of Microbiology/Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Qin He
- Department of Microbiology/Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Peter L. Rady
- Department of Microbiology/Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Thomas K. Hughes
- Department of Microbiology/Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Cyro Festa Neto
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | | | - Stephen K. Tyring
- Department of Microbiology/Immunology, University of Texas Medical Branch, Galveston, Texas
- Department of Dermatology, University of Texas Health Science Center, Houston, Texas
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Okita AL, Molina Tinoco LJ, Patatas OHG, Guerreiro A, Criado PR, Gabbi TVB, Ferreira PS, Neto CF. Use of Smartphones in Telemedicine: Comparative Study Between Standard and Teledermatological Evaluation of High-Complex Care Hospital Inpatients. Telemed J E Health 2016; 22:755-60. [DOI: 10.1089/tmj.2015.0086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Aline Lissa Okita
- Department of Dermatology, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Paulo Ricardo Criado
- Department of Dermatology, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | | | - Paula Silva Ferreira
- Department of Dermatology, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | - Cyro Festa Neto
- Department of Dermatology, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
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Tirico MC, Neto CF, Valente NYS, Nico MM. Sclerosing Lipogranuloma with Multiple Skin Lesions and Pulmonary Involvement, Secondary to a Factitious Disorder. Acta Derm Venereol 2016; 96:268-9. [PMID: 26315839 DOI: 10.2340/00015555-2229] [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] [Indexed: 11/16/2022] Open
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Abstract
BACKGROUND Epidermodysplasia verruciformis (EV) is a rare genodermatosis caused by specific human papillomavirus (HPV) types associated with the development of multiple squamous cell carcinomas (SCC). The treatment for this skin tumour may be difficult. Among the therapy options, radiotherapy (RT) should be avoided due to its deleterious effects on HPV-induced carcinogenesis. OBJECTIVE To describe 4 patients with EV who underwent radiotherapy to treat cutaneous SCC. METHODS This is a retrospective study. The evolution of cutaneous SCC after adjuvant radiotherapy in 4 patients with EV was observed. RESULTS This study included 4 patients with diagnosis of EV. All 4 of the patients had cutaneous SCC. They underwent surgical resection and adjuvant radiotherapy. Over a period of up to 2 years, there was aggressive tumour recurrence. CONCLUSION Radiotherapy might be associated with progression of SCC in patients with EV, and it is recommended that radiotherapy should be avoided in this patient population.
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Affiliation(s)
| | | | | | - Stephen Tyring
- The University of Texas Health Science Center, Houston, TX, USA
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23
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Grinblat BM, Festa Neto C, Sanches JA, Szeimies RM, Oliveira AP, Torezan LAR. Daylight photodynamic therapy for actinic keratoses in São Paulo, Brazil. Photodermatol Photoimmunol Photomed 2014; 31:54-6. [DOI: 10.1111/phpp.12127] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Beni Moreinas Grinblat
- Department of Dermatology; Hospital das Clinicas; University of Sao Paulo; Sao Paulo Brazil
| | - Cyro Festa Neto
- Department of Dermatology; Hospital das Clinicas; University of Sao Paulo; Sao Paulo Brazil
| | - Jose Antonio Sanches
- Department of Dermatology; Hospital das Clinicas; University of Sao Paulo; Sao Paulo Brazil
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de Paula Samorano-Lima L, Quitério LM, Sanches JA, Neto CF. Inpatient dermatology: profile of patients and characteristics of admissions to a tertiary dermatology inpatient unit in São Paulo, Brazil. Int J Dermatol 2013; 53:685-91. [PMID: 23675752 DOI: 10.1111/j.1365-4632.2012.05818.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dermatology is primarily an outpatient clinical and surgical specialty, but substantial numbers of patients are admitted to hospital for inpatient treatment in dermatology wards. METHODS We performed a retrospective study of patients admitted to dermatology beds between September 1, 2002, and September 30, 2010. Patient data were analyzed for age, gender, ethnicity, length of stay (LoS), dermatologic disease, comorbidities, hospital-acquired infection (HAI), transfer to the intensive care unit (ICU), and mortality. RESULTS A total of 3308 patients admitted during this 8-year period were identified for analysis. The most frequent admissions were for eczema/dermatitis (17.5%) and cutaneous infections (15.9%). The mean LoS was 13.0 days. The mean ± standard deviation (SD) number of comorbidities per patient was 1.0 ± 1.2, among the most frequent of which were hypertension and diabetes mellitus. The rate of HAI was 6.2%; bloodstream infection was regarded as the most commonly acquired type and Staphylococcus aureus as the infectious agent most commonly found in culture. Of the patients admitted, 3.7% were transferred to the ICU and 2.5% died. In these latter two groups, the most common dermatologic diagnoses were immunobullous diseases, and the mean hospital LoS and rate of HAI were higher than in the total admissions cohort. CONCLUSIONS Higher value should be placed on dermatology inpatient services in order to expand the availability of dermatology beds, mainly in tertiary hospitals, in view of the potentially high severity of the dermatologic diseases found in many patients referred to this type of service.
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Gascon MRP, Bonfim MC, Pedroso TG, Campos TR, Benute GRG, Aoki V, Takaoka R, Leão RO, Lúcia MCSD, Festa Neto C. Avaliação psicológica de crianças com dermatite atópica por meio do teste das fábulas de Düss. Estud Interdiscip Psicol 2012. [DOI: 10.5433/2236-6407.2012v3n2p182] [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: 11/10/2022] Open
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26
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Gascón MRP, Ribeiro CM, Bueno LMDA, Benute GRG, Lucia MCSD, Rivitti EA, Festa Neto C. Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital. An Bras Dermatol 2012; 87:403-7. [DOI: 10.1590/s0365-05962012000300008] [Citation(s) in RCA: 8] [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] [Received: 05/06/2011] [Accepted: 06/28/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: The objective of this study was to estimate the prevalence of depression and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in São Paulo, Brazil. OBJECTIVE: To assess the prevalence of mood and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in São Paulo. METHOD: A total of 75 patients, men and women, aged between 18 and 76 years, took part in the research. The study employed a descriptive, cross sectional and correlational method. The data was collected by means of a social demographic questionnaire and the PRIME-MD. RESULTS: It was found that 45.3 percent of the subjects presented with depressive symptoms, and 52 percent presented with symptoms of anxiety and that this survey showed moderate and high significant correlations (p<0,01; r= 0,616) for depression and anxiety. CONCLUSION: These facts could evidence the relationship between physical and psyche, just as the literature presents.
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Cabral LS, Festa Neto C, Sanches JA, Ruiz IRG. Genomic instability in human actinic keratosis and squamous cell carcinoma. Clinics (Sao Paulo) 2011; 66:523-8. [PMID: 21655741 PMCID: PMC3093780 DOI: 10.1590/s1807-59322011000400001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 12/07/2010] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the repetitive DNA patterns of human actinic keratoses and squamous cell carcinomas to determine the genetic alterations that are associated with malignant transformation. INTRODUCTION Cancer cells are prone to genomic instability, which is often due to DNA polymerase slippage during the replication of repetitive DNA and to mutations in the DNA repair genes. The progression of benign actinic keratoses to malignant squamous cell carcinomas has been proposed by several authors. MATERIAL AND METHODS Eight actinic keratoses and 24 squamous cell carcinomas (SCC), which were pair-matched to adjacent skin tissues and/or leucocytes, were studied. The presence of microsatellite instability (MSI) and the loss of heterozygosity (LOH) in chromosomes 6 and 9 were investigated using nine PCR primer pairs. Random Amplified Polymorphic DNA patterns were also evaluated using eight primers. RESULTS MSI was detected in two (D6S251, D9S50) of the eight actinic keratosis patients. Among the 8 patients who had squamous cell carcinoma-I and provided informative results, a single patient exhibited two LOH (D6S251, D9S287) and two instances of MSI (D9S180, D9S280). Two LOH and one example of MSI (D6S251) were detected in three out of the 10 patients with squamous cell carcinoma-II. Among the four patients with squamous cell carcinoma-III, one patient displayed three MSIs (D6S251, D6S252, and D9S180) and another patient exhibited an MSI (D9S280). The altered random amplified polymorphic DNA ranged from 70% actinic keratoses, 76% squamous cell carcinoma-I, and 90% squamous cell carcinoma-II, to 100% squamous cell carcinoma-III. DISCUSSION The increased levels of alterations in the microsatellites, particularly in D6S251, and the random amplified polymorphic DNA fingerprints were statistically significant in squamous cell carcinomas, compared with actinic keratoses. CONCLUSION The overall alterations that were observed in the repetitive DNA of actinic keratoses and squamous cell carcinomas indicate the presence of a spectrum of malignant progression.
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Lourenço SV, Bologna SB, Colucci F, Neto CF, Montenegro FLM, Nico MMS. Oral mucosal melanoma of the mandibular gingiva: a case report. Cutis 2010; 86:89-93. [PMID: 20919603] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Oral mucosal melanoma is rare and is reported to be more aggressive than cutaneous melanoma. The incidence of oral mucosal melanoma peaks at 41 to 60 years of age and the male to female ratio is 2 to 1. Preferred sites in the oral mucosa include the hard palate and maxillary alveolar crests. Risk factors have not been clearly identified, but melanotic pigmentation is present in one-third of patients prior to the diagnosis of melanoma. We report an unusual case of oral mucosal melanoma of the mandibular gingiva with the main characteristics of an in situ lesion and areas of superficial invasion in a 45-year-old woman. The patient was treated with surgical resection of the lesion and a 54-month follow-up shows no evidence of recurrence. Oral mucosal melanomas are aggressive neoplasms that may arise from prior pigmented lesions in the oral mucosa. Classification of these tumors is not well-established and the main prognostic factor appears to be lymph node compromise. The main treatment modality is surgical resection.
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Abstract
INTRODUCTION Dermatology is primarily an outpatient specialty, but it also plays an important role in the care of inpatients. METHODS We conducted a prospective study that recorded data from inpatient dermatology consultation request forms over a period of four months. The study evaluated 313 requests that led to 566 visits, 86 biopsies, 35 laboratory exams, 41 direct microscopic studies, 18 direct immunofluorescence analyses, 14 skin cultures and a few other exams. RESULTS The most frequent requesting service was internal medicine (24%), followed by neurology (12%), cardiology (11%), infectious diseases and pediatrics (8% each) and psychiatry and general surgery (6% each). The most frequent diagnostic groups were infectious diseases (25%, divided into fungal infections (13%), bacterial infections (7%) and viral infections (5%)), eczemas (15%) and drug reactions (14%). To our knowledge, this is the first study to attempt to evaluate the impact of the consultations by asking multiple-choice questions that were analyzed by the authors. In 31% of the cases, the consultation was considered extremely relevant because it aided in managing the disease that led to admission or treated a potentially severe dermatological disease. In 58% of the cases, the consultation was considered important because it facilitated diagnosis and/or treatment of a dermatological disease that was unrelated to the reason for admission.
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Affiliation(s)
- Suzana Mancusi
- Dermatology Department, Hospital das Clinicas, Universidade de São Paulo, SP, Brazil.
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Abstract
A terapia fotodinâmica envolve a administração de uma droga fotossensibilizante e sua ativação subsequente pela luz de comprimento de onda correspondente ao espectro de absorção do fotossensibilizador. Atualmente, a terapia fotodinâmica tópica é aprovada para o tratamento de condições oncológicas cutâneas como queratoses actínicas, doença de Bowen e carcinoma basocelular superficial em diversos países do mundo. Estudos multicêntricos controlados e randomizados demonstram a alta eficácia e resultado cosmético final superior dessa modalidade terapêutica em relação aos tratamentos convencionais. Para condições cutâneas não oncológicas, como acne vulgar, verrugas virais e esclerodermia localizada, há também relatos e série de casos confirmando o potencial terapêutico da terapia fotodinâmica. O desenvolvimento de fotossensibilizantes tópicos, ácido 5-aminolevulínico (ALA) ou seu metiléster (MAL), frente aos derivados da hematoporfirina de aplicação sistêmica, permitiu um grande avanço na popularidade da TFD na dermatologia, uma vez que tanto ALA quanto MAL tópicos não induzem mais fotossensibilidade generalizada prolongada. A produção de intermediários reativos de oxigênio, como oxigênio singlet, depende da concentração, da localização do fotossensibilizante no tecido alvo, assim como da dose de luz utilizada. Tanto as lâmpadas de amplo espectro quanto os LEDs (do inglês light emitting diodes) constituem fontes de luz adequadas para que os efeitos citotóxicos da terapia fotodinâmica resultem na destruição do tumor ou seus efeitos imunomodulatórios atuem melhorando as condições inflamatórias cutâneas.
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Alessi SS, Sanches JA, Oliveira WRD, Messina MC, Pimentel ERDA, Festa Neto C. Treatment of cutaneous tumors with topical 5% imiquimod cream. Clinics (Sao Paulo) 2009; 64:961-6. [PMID: 19841702 PMCID: PMC2763070 DOI: 10.1590/s1807-59322009001000005] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 07/13/2009] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION There are various approaches to the treatment of cutaneous tumors; one of them is treatment with imiquimod, a synthetic toll-like receptor agonist with a low molecular weight that offers a topical, noninvasive, and non-surgical therapeutic option. The main objective of our study was to provide data on 89 patients who used a 5% imiquimod cream for the treatment of cutaneous tumors at the Cutaneous Oncology Group of the Dermatology Department of Hospital das Clinicas from 2003 to 2008. MATERIALS AND METHODS Here, we present our experience in the treatment of 123 cutaneous tumors of various types, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Bowen's disease, erythroplasia of Queyrat, Paget's disease, and trichoepithelioma, with 5% imiquimod cream from 2003 to 2008 in the Cutaneous Oncology Group of the Dermatology Department of Hospital das Clinicas. Patients were divided into two separate groups according to their diagnosis and comorbidities; these comorbidities included epidermodysplasia verruciformis, xeroderma pigmentosum, albinism, basal cell nevus syndrome, Brooke-Spiegler syndrome, HIV, chronic lymphocytic leukemia, B-cell lymphoma, and kidney transplantation. Treatment duration, response to imiquimod, follow-up, recurrence, and local and systemic reactions associated with use of the drug were analyzed. Epidemiological data were obtained and cure rates were calculated. RESULTS The ratio of women to men was 1.28:1, and the mean age was 63.1 years. Tumors were located mainly on the face, back, trunk, and legs. For patients with comorbidities, the overall cure rate was 38%. These specific patients demonstrated cure rates of 83.5% for superficial BCC and 50% for Bowen's disease. Aggressive BCC and superficial and nodular BCC did not present a good response to treatment. Trichoepitheliomas and nodular BCC showed a partial response, and erythroplasia of Queyrat showed a complete response. For patients without comorbidities, the overall cure rate was 73%. For these patients, the cure rates were 85.7% for superficial and nodular BCC, 88% for superficial BCC, 57% for Bowen's disease, 50% for nodular BCC, and 50% for aggressive BCC. One SCC lesion demonstrated a complete response, and tumors caused by Paget's disease and erythroplasia of Queyrat presented a partial response. None of the tumors considered as clinically cured recurred. Thirty-seven lesions demonstrated no response to imiquimod. Having a cutaneous comorbidity, high-risk tumors such as mixed aggressive BCC (sclerodermiform or micronodular), nodular BCC, or Bowen's disease, and presenting no local reaction to imiquimod were considered as risk factors for a worse prognosis. We demonstrate that patients with no response to imiquimod, even when they demonstrated no local reaction, can undergo another cycle of six weeks of imiquimod treatment and show a complete response. The healing pattern led to good cosmetic outcomes, and the side effects were tolerable. CONCLUSIONS Our experience confirms imiquimod as an effective treatment option for several types of cutaneous tumors, especially in patients without the cutaneous comorbidities cited above and with low-risk tumors. Imiquimod has a relatively low cost compared to other therapeutic options and can be delivered via ambulatory care to patients with surgery contraindications, and its side effects are tolerable.
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Affiliation(s)
- Sabrina Sisto Alessi
- Dermatology Department, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Trindade MAB, Wen CL, Neto CF, Escuder MM, Andrade VLG, Yamashitafuji TMT, Manso VLS. Accuracy of store-and-forward diagnosis in leprosy. J Telemed Telecare 2008; 14:208-10. [PMID: 18534956 DOI: 10.1258/jtt.2008.071203] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Telemedicine might increase the speed of diagnosis for leprosy and reduce the development of disabilities. We compared the accuracy of diagnosis made by telemedicine with that made by in-person examination. The cases were patients with suspected leprosy at eight public health clinics in outlying areas of the city of São Paulo. The case history and clinical examination data, and at least two clinical images for each patient, were stored in a web-based system developed for teledermatology. After the examination in the public clinic, patients then attended a teaching hospital for an in-person examination. The benchmark was the clinical examination of two dermatologists at the university hospital. From August 2005 to April 2006, 142 suspected cases of leprosy were forwarded to the website by the doctors at the clinics. Of these, 36 cases were excluded. There was overall agreement in the diagnosis of leprosy in 74% of the 106 remaining cases. The sensitivity was 78% and the specificity was 31%. Although the specificity was low, the study suggests that telemedicine may be a useful low-cost method for obtaining second opinions in programmes to control leprosy.
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Terzian LR, Festa Neto C, Pimentel ERDA. Fatores preditivos do maior número de estádios na cirurgia micrográfica de Mohs para o tratamento do carcinoma espinocelular da cabeça. An Bras Dermatol 2008. [DOI: 10.1590/s0365-05962008000300005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
FUNDAMENTOS: Os carcinomas espinocelulares da pele da cabeça têm como opção terapêutica mais segura a cirurgia micrográfica de Mohs, que apresenta os menores índices de recidiva e a máxima preservação tecidual. Características dos carcinomas espinocelulares podem estar relacionadas a maior número de estádios cirúrgicos. OBJETIVO: Definir características dos carcinomas espinocelulares que sejam preditoras de maior número de estádios na cirurgia de Mohs. MÉTODOS: Análise retrospectiva de 51 carcinomas espinocelulares da cabeça tratados pela cirurgia de Mohs para determinar fatores de risco de maior número de estádios. Foram analisados limites clínicos, morfologia, recidiva, histologia e tamanho, relacionando-os ao número de estádios cirúrgicos. A análise estatística foi realizada pelo teste exato de Fisher e regressão logística multivariada. RESULTADOS: Os carcinomas recidivados tiveram tendência a maior número de estádios (p=0,081). Os tumores com limites imprecisos apresentaram três vezes mais possibilidades de maior número de fases na análise da razão de chances. Esse achado foi compatível com dados da literatura, apesar de não ter sido estatisticamente significante. CONCLUSÃO: Características pré-operatórias dos carcinomas espinocelulares, como recidiva e limites imprecisos, apesar de não preditivas, indicaram tendência a maior número de estádios na cirurgia micrográfica de Mohs.
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Affiliation(s)
- Luiz Roberto Terzian
- Faculdade de Medicina da Universidade de São Paulo; Faculdade de Medicina do ABC, Brasil
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Orimoto AM, Neto CF, Pimentel ERA, Sanches JA, Sotto MN, Akaishi E, Ruiz IRG. High numbers of human skin cancers express MMP2 and several integrin genes. J Cutan Pathol 2008; 35:285-91. [PMID: 18251742 DOI: 10.1111/j.1600-0560.2007.00810.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Basal cell carcinomas (BCC), squamous cell carcinomas (SCC) and cutaneous malignant melanoma (MM) are solid skin cancers derived from different cell types, with different ability to metastasize. Several subtypes of integrins and matrix metalloproteinases (MMP) have been related to malignization and metastasis processes. This work aimed at a quantitative evaluation of skin cancers expressing eight integrins and MMP2 genes. METHODS Expression of integrins and MMP2 genes was evaluated on fresh tumor biopsies from BCC, SCC and MM, and respective controls, by the reverse transcriptase polychain reaction (RT-PCR) technique. RESULTS More than 90% tumors expressed alpha6a, beta1, beta3 and beta6 (non-melanoma), and alpha5a, alpha6a and MMP2 (MM). Up to 100% controls also expressed beta1 and beta3. The results were significant for alpha6a in BCC (p = 0.026), alpha6b in SCC (p = 0.035), alpha2a in BCC (p = 0.003), beta5 and beta6 in BCC (p = 0.005). MMP2 was expressed in 100% MM (p = 0.0004). CONCLUSION Integrin subunits alpha2a and alpha6a would be interesting targets for BCC anti-tumor therapy, as well as alpha6b in case of SCC. The elevated number of BCC expressing alpha2 and alpha6, and of MM expressing alphav and MMP2, corroborate literature data.
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Abstract
Os cânceres cutâneos não melanoma são as neoplasias malignas mais comuns em humanos. O carcinoma basocelular e o carcinoma espinocelular representam cerca de 95% dos cânceres cutâneos não melanoma, o que os torna um crescente problema para a saúde pública mundial devido a suas prevalências cada vez maiores. As alterações genéticas que ocorrem no desenvolvimento dessas malignidades cutâneas são apenas parcialmente compreendidas, havendo muito interesse no conhecimento e determinação das bases genéticas dos cânceres cutâneos não melanoma que expliquem seus fenótipos, comportamentos biológicos e potenciais metastáticos distintos. Apresenta-se uma revisão atualizada da genética molecular aplicada aos cânceres cutâneos não melanoma, em especial ao carcinoma basocelular e carcinoma espinocelular, enfatizando os mais freqüentes genes e os principais mecanismos de instabilidade genômica envolvidos no desenvolvimento dessas malignidades cutâneas.
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Cardoso AO, Tayti T, Oliveira JPD, Torezan LA, Sotto MN, Vilela MA, Nico MMS, Osório NDS, Festa Neto C. Angioma em tufos: relato de um caso tratado com laser corante pulsado. An Bras Dermatol 2006. [DOI: 10.1590/s0365-05962006000900003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O angioma em tufos é quadro raro, benigno, de proliferação cutânea angiomatosa. Acomete mais crianças e clinicamente caracteriza-se por lesões em placas, vermelho-violáceas, dolorosas e mais freqüentes no tronco. Quando não regride espontaneamente, os tratamentos propostos (cirurgia convencional, corticoterapia, interferon e laser) alcançam pouco sucesso. Descreve-se o caso de uma menina de 11 anos, com angioma em tufos no tronco, tratada com laser corante pulsado que mostrou alívio importante da dor local e redução discreta do tamanho da lesão. A raridade de casos relatados no Brasil e a tentativa terapêutica com laser corante pulsado motivaram a divulgação do caso.
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Abstract
Os linfomas cutâneos de células T/NK constituem um grupo de doenças linfoproliferativas extranodais atualmente classificadas e subdivididas de acordo com o comportamento clínico segundo consenso da Organização Mundial de Saúde e da Organização Européia para Pesquisa e Tratamento do Câncer. Os linfomas cutâneos de células T/NK de comportamento clínico indolente compreendem a micose fungóide clássica, a micose fungóide foliculotrópica, a reticulose pagetóide, a cútis laxa granulomatosa, o linfoma cutâneo primário de grande célula anaplásica, a papulose linfomatóide, o linfoma subcutâneo de célula T paniculite-símile e o linfoma cutâneo primário de pequena e média célula T CD4+ pleomórfica. Os linfomas cutâneos de células T/NK de comportamento agressivo incluem a síndrome de Sézary, o linfoma extranodal de célula T/NK, tipo nasal, o linfoma cutâneo primário agressivo de célula T CD8+ epidermotrópica, o linfoma cutâneo de célula T <FONT FACE=Symbol>gd</FONT> e o linfoma cutâneo primário de célula T periférica, não especificado. O linfoma-leucemia de células T do adulto e a neoplasia hematodémica CD4+CD56+, embora considerados linfomas sistêmicos, são aqui abordados por apresentarem-se inicialmente na pele em significativo número de pacientes. O diagnóstico desses processos é realizado pelo exame histopatológico complementado pela análise do fenótipo das células neoplásicas, imprescindível no processo classificatório. O estadiamento para a avaliação da extensão anatômica da doença considera além do envolvimento cutâneo, o estado clínico e histológico dos linfonodos e das vísceras. Avaliação hematológica é fundamental na caracterização da síndrome de Sézary. Os tratamentos preconizados incluem terapêuticas dirigidas exclusivamente à pele, modificadores da resposta biológica e quimioterapia sistêmica.
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Francisco G, Neto CF, Sanches JA, Ruiz IRG. Genomic instability in basal cell carcinomas. J Dermatol Sci 2005; 39:186-8. [PMID: 16085392 DOI: 10.1016/j.jdermsci.2005.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Revised: 06/20/2005] [Accepted: 06/21/2005] [Indexed: 11/29/2022]
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Romão-Corrêa RF, Maria DA, Soma M, Sotto MN, Sanches JA, Neto CF, Ruiz IRG. Nucleolar organizer region staining patterns in paraffin-embedded tissue cells from human skin cancers. J Cutan Pathol 2005; 32:323-8. [PMID: 15811115 DOI: 10.1111/j.0303-6987.2005.00322.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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 Increased number of nucleoli (nucleolar organizer regions, NORs) with abnormal shapes and sizes, including small dots, has been used as prognostic tools to evaluate tumor proliferation levels and troublesome borderline lesions. In this study, NOR patterns of skin cancers were performed in the search of a valuable prognostic method to complement other histological procedures. METHODS Paraffin-embedded tumor tissue was obtained from basal and squamous cell carcinomas, cutaneous malignant melanoma, premalignant lesions, and Skmel-28 human melanoma cells. Slices were dewaxed and AgNOR stained. The patterns were scored and submitted for statistical analyses. RESULTS All types of cancer cells showed variable numbers of abnormally shaped nucleoli and dot-like structures. Only tumor cells presented four or more nucleoli, with or without dots, while 85% of the normal cells had one single NOR without dots. Most data were statistically significant when compared to normal cells. As a whole, squamous cell carcinoma and malignant melanoma tumor cells had less NOR alterations than basal cell carcinoma (BCC) tumor types. CONCLUSIONS Changes in the number and shape of nucleoli present in malignant cells could be attributed to increased levels on rDNA transcription on cancer cells, besides abnormal remodeling of chromatin, which could disrupt proper nucleoli association. Increased genetic alterations on malignant basal cells could contribute to impair invasive and migration abilities of BCC tumors.
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Romão-Corrêa RF, Ruiz IRG, Maria DA, Neto CF, Sanches JA. Ribosomal DNA exhibits few alterations in human skin cancers. J Dermatol Sci 2004; 34:109-11. [PMID: 15033193 DOI: 10.1016/j.jdermsci.2003.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2003] [Indexed: 11/22/2022]
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Ribeiro GRH, Francisco G, Teixeira LVS, Romão-Correia RF, Sanches JA, Neto CF, Ruiz IRG. Repetitive DNA alterations in human skin cancers. J Dermatol Sci 2004; 36:79-86. [PMID: 15519137 DOI: 10.1016/j.jdermsci.2004.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 04/06/2004] [Revised: 08/02/2004] [Accepted: 08/09/2004] [Indexed: 10/26/2022]
Abstract
Repetitive sequences constitute landmarks for genome regulation, evolution, and chromatin architecture. Patterns of specific and non-specific repetitive sequences change in many types and stages of tumor cells, characterized by band loss, gain, and (de) increased staining of pre-existing bands. In this work, repetitive DNA was studied in search of genome instability of skin cancers: basal and squamous cell carcinomas (BCC and SCC), malignant melanoma (MM), melanocytic nevus (MN), and actinic keratosis (AK) lesions. DNAs were extracted from blood and tumor samples from 21 BCC, 7 SCC, 11 MM and 7 lesions. Banding patterns were obtained by random amplification of polymorphic DNA (RAPD), and specific D9S50 and D9S52 microsatellites (9p21). D9S50 patterns revealed microsatellite instability (MSI) and/or loss of heterozygosity (LOH) in 36% BCC, 25% SCC, and 57% MM tumors. D9S52 microsatellite showed 28.5%; 42.8%; and 71.4% altered tumors, respectively. No microsatellite alterations were found in MN and AK. On the other hand, genomic rearrangements detected by RAPD were present in 100% tumors. In BCC, the mean number of tumor DNA alterations showed predominant gain of bands. On the contrary, MM samples presented loss, or decreased intensity signal of RAPD bands. Genome alterations in skin cancers would result from chromosomal rearrangements, aneuploidy and/or polysomies. The low-cost and quick RAPD technique may reveal unknown genes or DNA sequences associated with tumor development and progression, and may be easily implemented in clinical diagnosis.
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Affiliation(s)
- Gil R H Ribeiro
- Genetics Laboratory, Butantan Institute, Avenue Vital Brasil 1500, CEP 05503-900, São Paulo, SP, Brazil
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de Oliveira WRP, Neto CF, Rivitti EA. The lack of a clinical effect of cimetidine in the treatment of epidermodysplasia verruciformis. J Am Acad Dermatol 2004; 50:e14; author reply e15. [PMID: 15153919 DOI: 10.1016/j.jaad.2003.12.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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de Oliveira WRP, He Q, Rady PL, Hughes TK, Neto CF, Rivitti EA, Tyring SK. HPV typing in Brazilian patients with epidermodysplasia verruciformis: high prevalence of EV-HPV 25. J Cutan Med Surg 2004; 8:110-5. [PMID: 15129315 DOI: 10.1007/s10227-003-0100-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 09/26/2003] [Indexed: 11/24/2022]
Abstract
BACKGROUND Epidermodysplasia verruciformis is a rare genetic disorder characterized by development of lesions associated with HPV#5 or HPV#8 in early childhood; malignant transformation occurs in approximately half of individuals during adulthood. OBJECTIVE Our goal was to study the presence and spectrum of EV-HPV types in Brazilian EV patients, a population that had never been studied in this regard. PATIENTS AND METHODS Forty-one biopsies from different lesions (benign and skin tumors) and one biopsy from clinically normal skin from each of 20 Brazilian patients with EV were studied for HPV typing using nested PCR. RESULTS EV-HPV DNA was detected in all 41 skin lesions of the patients and was also identified in specimens considered as normal skin from 8 patients (40%). In this study HPV-EV 25 was the most prevalent (70%), and HPV 14d (67%) was highly associated with malignant lesions. CONCLUSION EV-HPV 25 was the most prevalent in our study. The noteworthy association of EV-HPV type 14d with skin cancers suggests its possible oncogenic role in malignant transformation in this population.
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de Oliveira WRP, Rady PL, Grady J, Hughes TK, Festa Neto C, Rivitti EA, Tyring SK. Polymorphisms of the interleukin 10 gene promoter in patients from Brazil with epidermodysplasia verruciformis. J Am Acad Dermatol 2003; 49:639-43. [PMID: 14512909 DOI: 10.1067/s0190-9622(03)01567-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [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: 11/22/2022]
Abstract
BACKGROUND Epidermodysplasia verruciformis (EV) is a rare genetic disorder characterized by development of lesions associated with human papillomavirus in early childhood and malignant transformation in approximately half of individuals during adulthood. The persistence of human papillomavirus infection in EV is thought to be a result of an immunogenetic defect, which determines the generation of several cytokines capable of down-regulating cell-mediated immunity. OBJECTIVE We sought to study the prevalence of interleukin 10 (IL-10) promoter polymorphisms in skin biopsy specimens of patients with EV compared with DNA samples from healthy individuals. Patients and methods DNA samples extracted from normal skin of 22 patients from Brazil with EV and blood samples from 27 healthy Brazilian individuals were studied for IL-10 promoter polymorphisms using restriction fragment length polymorphism analysis. RESULTS The patients with EV showed an increased rate of low-production genotypes of IL-10 compared with control subjects (P =.003). Patients with EV and skin cancer were more likely to have low-production IL-10 genotypes than patients with benign forms of EV. CONCLUSION IL-10 genotypes associated with low levels of IL-10 production may have an important role in the pathogenesis of EV, including the susceptibility for development of skin cancer in patients with EV.
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Pereira de Oliveira WR, Carrasco S, Neto CF, Rady P, Tyring SK. Nonspecific cell-mediated immunity in patients with epidermodysplasia verruciformis. J Dermatol 2003; 30:203-9. [PMID: 12692356 DOI: 10.1111/j.1346-8138.2003.tb00372.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2002] [Accepted: 01/15/2003] [Indexed: 11/29/2022]
Abstract
Epidermodysplasia verruciformis (EV) is a rare disease that usually begins in childhood and is characterized by a generalized infection by human papilloma virus (HPV), frequent associations with cutaneous carcinomas, and abnormalities of cell-mediated immunity (CMI). We studied nonspecific CMI in 13 patients with EV by bacterial skin tests, allergic reactions to dinitrochlorobenzene (DNCB), measurement of responses to phytohemagglutinin (PHA), and quantification of T lymphocytes and T lymphocytes subsets in peripheral blood. Impairment of CMI was manifested by the cutaneous anergy to a variety of common skin antigens and, by the reduction of the lymphocyte transformation to PHA. There were no correlation between the severity of cases and abnormalities of CMI in our patients, however; the impairment of CMI was lower in cases of short duration, suggesting that the impairment of CMI in EV might reflect a long period of disease.
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Oliveira MR, Wen CL, Neto CF, Silveira PSP, Rivitti EA, Böhm GM. Web site for training nonmedical health-care workers to identify potentially malignant skin lesions and for teledermatology. Telemed J E Health 2003; 8:323-32. [PMID: 12419026 DOI: 10.1089/15305620260353216] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 01/06/2023] Open
Abstract
The development of a Web site to enable nonmedical health professionals to screen skin potentially malignant skin lesions is described. A nurse assistant and a dermatologist tested the Web site. An electronic clinical form was developed to allow a nurse assistant to send case reports and photographs for remote diagnosis by a dermatologist. The nurse assistant photographed the lesions of 92 patients who presented some kind of dermatological condition. The images were then sent for evaluation by the dermatologist followed by in person examination by the same physician. The diagnoses, which resulted from the examination in person and, in some cases, the biopsy results, were compared with the diagnostic impressions of the nurse assistant and with the diagnostic hypothesis of the dermatologist at a distance. The lesions were classified as either malignant or nonmalignant. Kappa statistics showed a high association between the suspected malignity and nonmalignity of the lesions between the dermatologist (p = 6.01 x 10(-9)) and the nurse assistant and between the diagnosis at distance and in person (p < 1.0 x 10(-14)). The Web site allowed a nurse assistant to screen for potentially malignant skin lesions and, thus, proved to be appropriate for a large-scale test.
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Affiliation(s)
- Marcela R Oliveira
- Discipline of Telemedicine, Faculty of Medicine of the University of São Paulo, São Paulo, Brazil
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Roncalli de Oliveira W, Neto CF, Rady PL, Tyring SK. Seborrheic Keratosis-like lesions in patients with epidermodysplasia verruciformis. J Dermatol 2003; 30:48-53. [PMID: 12598709] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2002] [Accepted: 11/19/2002] [Indexed: 03/01/2023]
Abstract
Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by disseminated infection by human papillomavirus (HPV) and malignant transformation of the lesions in about half of the patients. Two phenotypes of EV have been described according to their propensity to develop malignant tumors. The benign form of EV presents a singular type of lesions comprised of flat warts widely disseminated. The malignant form of EV is highly polymorphic and presents as malignant skin tumors, predominantly basal and squamous cell carcinomas, on sun-exposed sites. The seborrheic keratosis-like (SK) lesions in patients of EV have been reported to be associated with the malignant phenotype. In this work, we documented the behavior of SK-like lesions in nine patients with EV, through clinical observations as well as histological and immunohistochemical findings. We suggest that the HPV infection may promote the occurrence of SK-like lesions in EV patients. Despite the fact that we did not observe any malignant transformation of these lesions in our series of patients, this possibility was not completely excluded.
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Abstract
BACKGROUND: Topical treatment with 5% imiquimod cream has been demonstrated to be effective in patients with basal cell carcinoma. OBJECTIVES: In the present study, efficacy and tolerability of this treatment was analyzed in 10 patients with 13 different types of superficial and nodular basal cell carcinomas. METHODS: Imiquimod cream was applied daily for a mean period of 23 days. RESULTS AND CONCLUSIONS: All patients responded favorably to the drug with healing of the lesions. No recurrence was observed during two to three months of follow up.
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Abstract
FUNDAMENTOS: A epidermodisplasia verruciforme (EV) é genodermatose rara, caracterizada por infecção disseminada por tipos específicos de vírus papiloma humano (HPV), desenvolvimento de tumores cutâneos malignos e distúrbios imunológicos. OBJETIVOS: Correlacionar aspectos clínicos em 13 doentes com EV, na tentativa de contribuir para melhor conhecimento da enfermidade. MÉTODOS:Avaliação clínica de 13 doentes com EV durante o período de três anos. O diagnóstico clínico foi confirmado pelo exame histopatológico e imuno-histoquímico. RESULTADOS: A EV teve início na infância com lesões de verruga plana-símile e/ou máculas eritematosa na face e região cervical. A consangüinidade foi observada na maioria dos doentes (12/13). Clinicamente, o polimorfismo das lesões foi intenso, caracterizado por lesões de verruga plana-símile, pitiríase versicolor-símile, máculas eritematosas e lesões de queratose seborréica-símile. A transformação maligna das lesões foi observada em oito doentes (62%). O crescimento tumoral provocou perda tecidual importante em 50% dos casos, e em 25% foi registrado óbito pelas metástases. CONCLUSÃO: A EV apresenta alta incidência familiar e provável transmissão autossômica recessiva. O intenso polimorfismo clínico das lesões não afeta o couro cabeludo e mucosas. A apresentação clínica "maligna" foi a mais freqüente (62%), seguida pela "benigna" (23%) e "mista" (15%). Os tumores cutâneos malignos são freqüentes, múltiplos, destrutivos, geram metástases e provocam morte.
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Affiliation(s)
| | | | - Stephen K Tyring
- Universidade de São Paulo; Departamento de Microbiologia e Imunologia, EUA
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