25 results on '"Follador I"'
Search Results
2. Post-kala-azar dermal leishmaniasis associated with AIDS
- Author
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Bittencourt Achiléa, Silva Nancy, Straatmann Andréa, Nunes Victor Luiz Correia, Follador Ivonise, and Badaró Roberto
- Subjects
Visceral leishmaniasis ,post-kala-azar dermal leishmaniasis ,AIDS ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.
- Published
- 2003
3. Post-kala-azar dermal leishmaniasis associated with AIDS
- Author
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Bittencourt Achiléa, Silva Nancy, Straatmann Andréa, Nunes Victor Luiz Correia, Follador Ivonise, and Badaró Roberto
- Subjects
Visceral leishmaniasis ,post-kala-azar dermal leishmaniasis ,AIDS ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.
- Published
- 2002
4. Ocular complications in adults with psoriasis: a cross-sectional study in a referral center in Brazil.
- Author
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Oliveira RDC, Faneli AC, Amaral DC, Chagas JM, Guedes J, Follador I, de Oliveira MFSP, Fernandes BF, and Correia LCL
- Subjects
- Humans, Cross-Sectional Studies, Male, Female, Brazil epidemiology, Adult, Middle Aged, Prevalence, Meibomian Gland Dysfunction epidemiology, Meibomian Gland Dysfunction diagnosis, Meibomian Gland Dysfunction etiology, Severity of Illness Index, Aged, Young Adult, Psoriasis epidemiology, Psoriasis complications, Dry Eye Syndromes epidemiology, Dry Eye Syndromes etiology, Dry Eye Syndromes diagnosis
- Abstract
Purpose: There is limited literature on the ocular manifestations in patients with psoriasis. Therefore, this study aimed to identify the prevalence of and factors associated with ocular manifestations in adults with psoriasis., Methods: This cross-sectional study included Brazilian adults with psoriasis. The dermatological evaluation included diagnosis, clinical form, Psoriasis Area and Severity Index (PASI) measurement, and location of the lesions. Patients underwent a full ophthalmological examination, including the Schirmer I test, Rose Bengala staining, and tear breakup time tests. The results were analyzed using chi-square and Pearson's linear correlation tests., Results: Of the 130 patients assessed, 118 (90.8%) exhibited ocular abnormalities, with meibomian gland dysfunction (MGD) being the most prevalent (59.2%), followed by dry eye disease (DED) (56.2%). A significant correlation was observed between MGD and PASI (p = 0.05), and between MGD and certain treatment modalities. DED was significantly associated with PASI (p < 0.05). Concurrent use of acitretin was identified as an independent predictor of MGD (odds ratio [OR] = 3.5, p < 0.05), whereas PASI was a protective factor against DED (OR = 0.39, p < 0.01)., Conclusion: Given the high prevalence of eye disease among individuals with psoriasis, routine ophthalmological assessments are recommended to prevent possible ocular complications., (© 2024. The Author(s).)
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- 2024
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5. How persistent stigma and discrimination keep people with visible skin diseases out of jobs: vitiligo in Brazil today.
- Author
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Silveira LP, Grijsen ML, Follador I, and Dellatorre G
- Abstract
Competing Interests: LPS, MLG, IF, GD: We declare no competing interests.
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- 2023
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6. Epidemiological profile of rosacea in dermatology outpatient clinics in Brazil: an observational report from the Brazilian study group on rosacea.
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Suarez MV, Francesconi F, Gonçalves H, Dal Forno T, Ribeiro BM, Mulinari-Brenner F, Costa IMC, Filho JWA, Cunha MG, Follador I, Cotrim P, Neves JR, Brito MFM, Francesconi VA, Pontes MAA, Queiroz AJR, Rego V, Zink BS, and Marques LP
- Subjects
- Humans, Brazil epidemiology, Cross-Sectional Studies, Erythema complications, Dermatology, Rosacea epidemiology, Rosacea complications
- Abstract
Background: Rosacea prevalence varies worldwide and there is a lack of information in Brazil., Objectives: To describe the epidemiological profile of rosacea in subjects who consulted in dermatological outpatient clinics in Brazil., Materials & Methods: A cross-sectional study was conducted in 13 dermatological outpatient clinics across the country. Patients with rosacea diagnosis were eligible for the study according to the investigator's clinical assessment. Clinical, social and demographic data were collected. The overall and regional rosacea prevalence was calculated, and association with baseline characteristics was analysed., Results: A total of 3,184 subjects were enrolled, and rosacea prevalence was 12.7%. The southern region of Brazil presented a higher prevalence, followed by the southeast. The subjects in the rosacea group were older than those without rosacea (52.5 ±14.9 vs. 47.5 ±17.5; p<0.001). Moreover, the rosacea group was associated with Fitzpatrick's phototypes I and II, Caucasian ethnicity, a family history of rosacea, and facial erythema, however, no association with gender was found. The most prevalent clinical sign and clinical subtype in rosacea patients were erythema and erythematotelangiectatic, respectively., Conclusion: Rosacea is highly prevalent in Brazil, mostly in the southern region, associated with phototypes I and II and a family history.
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- 2023
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7. Consensus on the treatment of vitiligo - Brazilian Society of Dermatology.
- Author
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Dellatorre G, Antelo DAP, Bedrikow RB, Cestari TF, Follador I, Ramos DG, and Silva de Castro CC
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- Brazil epidemiology, Consensus, Humans, Quality of Life, Treatment Outcome, Dermatology, Ultraviolet Therapy, Vitiligo therapy
- Abstract
Background: Vitiligo is a muco-cutaneous, autoimmune, localized, or disseminated disease, which manifests through hypochromic or achromic macules, with loss in quality of life. The prevalence of vitiligo in Brazil was determined to be 0.54%. There is no on-label medication for its treatment. To date, no Brazilian consensus on the treatment of vitiligo had been written., Objectives: The objective of this group of Brazilian dermatologists with experience in the treatment of this disease was to reach a consensus on the clinical and surgical treatment of vitiligo, based on articles with the best scientific evidence., Methods: Seven dermatologists were invited, and each was assigned two treatment modalities to review. Each treatment (topical, systemic, and phototherapy) was reviewed by three experts. Two experts reviewed the surgical treatment. Subsequently, the coordinator compiled the different versions and drafted a text about each type of treatment. The new version was returned to all experts, who expressed their opinions and made suggestions for clarity. The final text was written by the coordinator and sent to all participants to prepare the final consensus., Results/conclusion: The experts defined the following as standard treatments of vitiligo: the use of topical corticosteroids and calcineurin inhibitors for localized and unstable cases; corticosteroid minipulse in progressive generalized vitiligo; narrowband UVB phototherapy for extensive forms of the disease. Surgical modalities should be indicated for segmental and stable generalized vitiligo. Topical and systemic anti-JAK drugs are being tested, with promising results., (Copyright © 2020 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2020
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8. Diagnosis and underdiagnosis of comorbidities in psoriasis patients - need for a multidisciplinary approach.
- Author
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Duarte GV, Oliveira MF, Follador I, Silva TS, and Carvalho EM Filho
- Subjects
- Adult, Body Mass Index, Brazil epidemiology, Cardiovascular Diseases etiology, Comorbidity, Cross-Sectional Studies, Diabetes Mellitus diagnosis, Dyslipidemias diagnosis, Female, Humans, Hypertension diagnosis, Male, Middle Aged, Prevalence, Risk Factors, Severity of Illness Index, Smoking adverse effects, Statistics, Nonparametric, Waist Circumference, Diabetes Mellitus epidemiology, Dyslipidemias epidemiology, Hypertension epidemiology, Psoriasis epidemiology
- Abstract
Background:: Psoriasis is an immune-mediated disease that manifests predominantly in the skin, although systemic involvement may also occur. Although associated comorbidities have long been recognized and despite several studies indicating psoriasis as an independent risk factor for cardiovascular events, little has been done in general medical practice regardind screening. In the United States, less than 50% of clinicians are aware of these recommendations., Objective:: To identify the prevalence of these comorbidities in 296 patients followed up at a university dermatology clinic., Methods:: Systematically investigated comorbidity frequencies were compared with general practitioners' registry frequencies. Clinical features correlated with comorbidities were also investigated., Results:: High prevalences of systematically investigated comorbidities such as hypertension (30%) and dyslipidemia (26.5%) were documented. Conversely, data from general practitioners' records showed that 33% of dyslipidemia cases were undiagnosed and indicated possible underdiagnosis of some comorbidities. Furthermore, an association was found between: the number of comorbidities and psoriasis duration, age and high body mass index an association was found between the number of comorbidities and psoriasis duration, age, high body mass index, waist circumference or waist-to-hip ratio. (p<0.05)., Conclusion:: Disease duration, age and high body mass index, waist circumference or waist-to-hip ratio are possible criteria for choosing which patients should be screened for comorbidities. Underdiagnosis of comorbidities by general practitioners highlights the need for a multidisciplinary approach in psoriasis management., Competing Interests: Dr. Duarte, Dr Follador and Dr. Oliveira have participated as speakers for AbbVie, Janssen and Pfizer in the last five years
- Published
- 2016
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9. Multicenter study for efficacy and safety evaluation of a fixeddose combination gel with adapalen 0.1% and benzoyl peroxide 2.5% (Epiduo® for the treatment of acne vulgaris in Brazilian population.
- Author
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Sittart JA, Costa Ad, Mulinari-Brenner F, Follador I, Azulay-Abulafia L, and Castro LC
- Subjects
- Acne Vulgaris pathology, Adolescent, Adult, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Brazil, Child, Dose-Response Relationship, Drug, Female, Humans, Male, Patient Satisfaction, Reproducibility of Results, Severity of Illness Index, Statistics, Nonparametric, Time Factors, Treatment Outcome, Young Adult, Acne Vulgaris drug therapy, Adapalene, Benzoyl Peroxide Drug Combination administration & dosage, Dermatologic Agents administration & dosage
- Abstract
Background: The current options for the treatment of acne vulgaris present many mechanisms of action. For several times, dermatologists try topical agents combinations, looking for better results., Objectives: To evaluate the efficacy, tolerability and safety of a topical, fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel for the treatment of acne vulgaris in the Brazilian population., Methods: This is a multicenter, open-label and interventionist study. Patients applied 1.0 g of the fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel on the face, once daily at bedtime, during 12 weeks. Lesions were counted in all of the appointments, and the degree of acne severity, overall improvement, tolerability and safety were evaluated in each visit., Results: From 79 recruited patients, 73 concluded the study. There was significant, fast and progressive reduction of non-inflammatory, inflammatory and total number of lesions. At the end of the study, 75.3% of patients had a reduction of >50% in non-inflammatory lesions, 69.9% in inflammatory lesions and 78.1% in total number of lesions. Of the 73 patients, 71.2% had good to excellent response and 87.6% had satisfactory to good response. In the first week of treatment, erythema, burning, scaling and dryness of the skin were frequent complaints, but, from second week on, these signals and symptoms have reduced., Conclusion: The fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel is effective, safe, well tolerated and apparently improves patient compliance with the treatment.
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- 2015
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10. Anti-TNFα therapy in the management of psoriasis: experience of a state referral center.
- Author
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Silva LM, Rocha Bde O, Nobre AC, Rêgo VR, Follador I, and Oliveira Mde F
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- Adalimumab, Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Etanercept, Female, Humans, Immunoglobulin G therapeutic use, Immunologic Factors therapeutic use, Infliximab, Male, Middle Aged, Receptors, Tumor Necrosis Factor therapeutic use, Retrospective Studies, Time Factors, Treatment Outcome, Young Adult, Anti-Inflammatory Agents therapeutic use, Psoriasis drug therapy, Tumor Necrosis Factor-alpha antagonists & inhibitors
- Abstract
Background: Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis., Objectives: We report the experience of a state referral center that uses anti-TNFα agents for psoriasis., Methods: We conducted a retrospective case series. Seventy-four out of 120 patients met the inclusion criteria. Clinical and laboratory data was analyzed using the chi-squared, Wicoxon and McNemar's tests. Associations were considered statistically significant when p-value<0.05., Results: Forty-one subjects (55.40%) were male, with a mean age of 47.69 ± 14.99 years. Median disease duration and pre-treatment PASI were 14.0 months (IQR 9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient response to conventional therapies was the principal indication for using anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects occurred in 6.80% of patients. Infections and elevation of transaminases occurred in 28.40% and 8.10% of cases, respectively., Conclusion: Post-treatment reduction in PASI was satisfactory and the occurrence of adverse effects was minor, mostly mild infusion effects and local reactions at drug administration sites.
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- 2014
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11. The linkage between psoriasis and non-alcoholic fatty liver disease: a literature review.
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Ramos AN, de Oliveira Rocha B, de Almeida Rêgo VR, Follador I, and de Oliveira MF
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- Humans, Inflammation complications, Insulin Resistance, Risk Factors, Severity of Illness Index, Non-alcoholic Fatty Liver Disease complications, Psoriasis complications
- Abstract
Psoriasis is a chronic systemic inflammatory disease mainly affecting the skin. Population-based surveys have shown a higher prevalence of non-alcoholic fat liver disease (NAFLD) in patients with psoriasis compared with the general population, especially in those with a greater psoriasis area and severity index (PASI). It is speculated that similar pathogenic bases may play a role in this association, highlighting insulin resistance and the release of inflammatory cytokines as the most likely causes. In the present work, we review basic aspects of the relationship between psoriasis and NAFLD.
- Published
- 2014
12. Disseminated extragenital lichen sclerosus et atrophicus treated with acitretin.
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Formiga Ade A, Torres Ide S, Rocha Bde O, Silva AO, Follador I, Rêgo VR, and de Oliveira Mde F
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- Female, Follow-Up Studies, Humans, Lichen Sclerosus et Atrophicus pathology, Middle Aged, Treatment Outcome, Acitretin therapeutic use, Keratolytic Agents therapeutic use, Lichen Sclerosus et Atrophicus drug therapy
- Published
- 2014
13. Acquired cutis laxa with an interstitial granulomatous reaction associated with IgG lambda monoclonal gammopathy.
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Silveira L, Torres I, Salvino MA, Follador I, and Bittencourt AL
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- Adult, Biomarkers analysis, Biopsy, Cutis Laxa immunology, Cutis Laxa pathology, Early Diagnosis, Elastic Tissue pathology, Granuloma immunology, Granuloma pathology, Humans, Immunohistochemistry, Immunophenotyping, Male, Paraproteinemias diagnosis, Paraproteinemias immunology, Predictive Value of Tests, Skin immunology, Cutis Laxa etiology, Granuloma etiology, Immunoglobulin G analysis, Immunoglobulin lambda-Chains analysis, Paraproteinemias complications, Skin pathology
- Abstract
Acquired cutis laxa (ACL) is a rare connective tissue disorder that affects the skin elastic fibers, resulting in the loss of elasticity. In 50% of cases, this condition is associated with other diseases, particularly plasma-cell dyscrasias. This report describes a case of ACL with unusual clinical and histopathological characteristics. A 29-year-old man presented with diffuse erythematous plaques that had first appeared 5 months previously. Examination revealed multiple flaccid erythematous plaques on his trunk, neck, and skinfolds. Immunophenotyping of bone marrow aspirate revealed 7% of monoclonal plasma cells with lambda light chain expression. Skin biopsy histology revealed foci of interstitial granulomatous reaction. Weigert stain showed a loss of elastic fibers in the dermis, areas with thickened fibers and elastophagocytosis. Immunohistochemistry was positive for CD68. The cutaneous findings enabled an early diagnosis of IgG lambda monoclonal gammopathy to be made. Microscopic examination revealed an interstitial granulomatous reaction and severe alterations in the elastic fibers that varied in intensity in the different biopsies. Curiously, little has been mentioned in the literature regarding the presence of an interstitial granulomatous reaction in ACL. It is our belief that this reaction is secondary to the degenerative process of the elastic fibers.
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- 2013
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14. Inherited epidermolysis bullosa: clinical and therapeutic aspects.
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Boeira VL, Souza ES, Rocha Bde O, Oliveira PD, Oliveira Mde F, Rêgo VR, and Follador I
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- Bandages, Humans, Skin pathology, Wound Healing, Epidermolysis Bullosa classification, Epidermolysis Bullosa genetics, Epidermolysis Bullosa pathology, Epidermolysis Bullosa therapy
- Abstract
Inherited epidermolysis bullosa (EB) is a heterogeneous group of genetic disorders that present with skin and, in some cases, mucosal fragility, predisposing patients to the development of blisters and/or erosions after minimal trauma or friction. Children with a recurrent history of these kinds of lesions or neonates that present them in the absence of another reasonable explanation should be investigated. Diagnosis must be based on clinical and histopathological findings. To date, management of inherited EB basically consists in avoiding traumas that trigger lesions, as well as preventing infection and facilitating healing of the wounds with the systematic use of bandages.
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- 2013
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15. Association between obesity measured by different parameters and severity of psoriasis.
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Duarte GV, Oliveira Mde F, Cardoso TM, Follador I, Silva TS, Cavalheiro CM, Nonato W, and Carvalho EM
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- Adult, Comorbidity, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Overweight epidemiology, Prevalence, Sex Distribution, Waist Circumference, Waist-Hip Ratio, Body Mass Index, Obesity epidemiology, Psoriasis epidemiology, Severity of Illness Index
- Abstract
Background: Obesity has been associated with the severity of psoriasis, but this relationship is not completely understood., Objectives: This study aimed to evaluate associations between the severity of psoriasis and weight excess as determined using a variety of parameters., Methods: A cross-sectional study was performed in 296 psoriasis patients. Their body mass index (BMI), waist circumference (WC), and waist : hip ratio (WHR) values were compared with results on a psoriasis area severity index (PASI)., Results: The frequency of severe psoriasis was higher in men (P < 0.05). Direct correlations were established between PASI scores and each of BMI (R = 0.0154, P = 0.01), WC (R = 0.207, P = 0.001), and WHR (R = 0.164, P = 0.007)., Conclusions: This study extends previous reports of an association between psoriasis and obesity and shows a direct correlation between obesity as measured according to different parameters and psoriasis severity., (© 2012 The International Society of Dermatology.)
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- 2013
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16. Psoriasis and uveitis: a literature review.
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Fraga NA, Oliveira Mde F, Follador I, Rocha Bde O, and Rêgo VR
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- Female, Humans, Male, Risk Factors, Psoriasis complications, Uveitis etiology
- Abstract
Psoriasis is a systemic, chronic, immunologically mediated disease, with significant genetic and environmental influences. It affects from 1 to 3% of the world population. Recently, the relation between psoriasis and different comorbidities, particularly metabolic syndrome, has become extremely relevant. Uveitis is characterized by a process of intraocular inflammation resulting from various causes. Considering psoriasis and uveitis as immune-mediated diseases, this study aims to evaluate the possible association of psoriasis and/or psoriatic arthritis with uveitis and its subtypes. Few studies have evaluated the association of uveitis and psoriasis without joint involvement. It seems that psoriasis without arthropathy is not a risk factor for the development of uveitis. Uveitis tends to develop more frequently in patients with arthropathy or pustular psoriasis than in patients with other forms of psoriasis. Ophthalmic examination should be performed periodically in patients with psoriasis and uveitis. If ophthalmopathy is diagnosed, the patient should receive adequate treatment with anti-inflammatory drugs or immunomodulators to prevent vision loss.
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- 2012
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17. Keratosis lichenoides chronica--case report.
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Martins LC, Horne M, Moreira Júnior DN, Follador I, and Almeida VR
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- Acitretin therapeutic use, Adult, Anti-Infective Agents therapeutic use, Biopsy, Chronic Disease, Dapsone therapeutic use, Humans, Keratolytic Agents therapeutic use, Keratosis drug therapy, Lichenoid Eruptions drug therapy, Male, Skin pathology, Keratosis pathology, Lichenoid Eruptions pathology
- Abstract
Keratosis lichenoides chronica or Nekam's disease is a rare mucocutaneous dermatosis characterized by keratinization. It is chronic and progressive usually affecting individuals aged 20-40 years. Around 70 cases have been reported in the literature. Due to the rarity of this condition and the lack of effective treatment, it is a difficult disease to manage. In the case described below we present a 42-year old patient with violaceous and hyperkeratotic papules in linear, reticular or plaque form, located on the trunk and limbs for five years. Aphthous lesions in the oral cavity and shallow ulcers on the genitalia also formed part of the clinical manifestation. Pathologic examination was suggestive of keratosis lichenoides chronica. Acitretin and dapsone was introduced and the lesions partially improved.
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- 2011
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18. Refractory erythrodermic psoriasis in a child with an excellent outcome by using etanercept.
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Fraga NA, Paim Mde F, Follador I, Ramos AN, and Rêgo VR
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- Child, Drug Therapy, Combination methods, Etanercept, Female, Humans, Dermatitis, Exfoliative drug therapy, Immunoglobulin G therapeutic use, Immunosuppressive Agents therapeutic use, Methotrexate therapeutic use, Psoriasis drug therapy, Receptors, Tumor Necrosis Factor therapeutic use
- Abstract
Psoriasis affects 0.12% to 0.71% of all children. Erythrodermic psoriasis is an uncommon but serious disorder, occurring in less than 1.5% of cases. Tumor necrosis factor-alpha blockers (TNF-α) are a new class of drugs used to treat moderate to severe psoriasis refractory to conventional therapies. Etanercept is a TNFα receptor fusion protein, approved by the FDA for treating juvenile rheumatoid arthritis. We present the case of a 7-year-old suffering from plaque psoriasis since 8 months old which evolved into erythroderma refractory to cyclosporine and methotrexate. Patient responded excellently to etanercept, with no adverse side effects.
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- 2011
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19. Childhood pustular psoriasis: case report.
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Chaves YN, Cardoso DN, Jorge PF, Follador I, and Oliveira Mde F
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- Cyclosporine therapeutic use, Dapsone therapeutic use, Dermatologic Agents therapeutic use, Humans, Infant, Male, Psoriasis drug therapy, Psoriasis pathology
- Abstract
Generalized pustulous psoriasis is a rare type of psoriasis first described in 1910 by Von Zumbusch. This disease tends to have a more benign development in children when compared to its development in adults. However, in its serious form it may represent a risk to the patient's life. Maybe, due to being such a rare disease no therapeutic option has so far consistently proved to be both effective and safe. Isolated reports suggest that retinoid is the best choice of drug in these cases. However, it is difficult to manage this drug in early infancy. The present report describes a serious case of this rare disease in an infant with a satisfactory response and good tolerance to the use of dapsone.
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- 2010
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20. Psoriasis and obesity: literature review and recommendations for management.
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Duarte GV, Follador I, Cavalheiro CM, Silva TS, and Oliveira Mde F
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- Chronic Disease, Humans, Inflammation complications, Inflammation therapy, Obesity therapy, Practice Guidelines as Topic, Obesity complications, Psoriasis etiology
- Abstract
Recent studies have found a relationship between obesity and chronic inflammation, confirmed by the association of high levels of tumor necrosis factor (TNF-_), interleukin six (IL-6,) and reactive C-protein with an increase in body mass index (BMI). In obese individuals, this inflammatory condition could contribute to the development or aggravation of psoriasis. Analogous phenomena have already been described in other inflammatory chronic diseases, such as rheumatoid arthritis and Crohn's disease. Epidemiological studies have identified a high prevalence of cardiovascular comorbidities, secondary to the metabolic alterations associated with psoriasis and obesity. A few aspects of this association remain unclear, such as the impact of obesity in the clinical forms of dermatoses, in the response to treatment, and its relationship with comorbidities.
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- 2010
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21. Enhanced Leishmania braziliensis infection following pre-exposure to sandfly saliva.
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de Moura TR, Oliveira F, Novais FO, Miranda JC, Clarêncio J, Follador I, Carvalho EM, Valenzuela JG, Barral-Netto M, Barral A, Brodskyn C, and de Oliveira CI
- Subjects
- Animals, Blotting, Western, Dermis immunology, Dermis parasitology, Ear Diseases immunology, Ear Diseases parasitology, Enzyme-Linked Immunosorbent Assay, Female, Flow Cytometry, Humans, Interferon-gamma metabolism, Interleukin-4 metabolism, Leishmania braziliensis immunology, Leishmaniasis, Cutaneous parasitology, Mice, Mice, Inbred BALB C, Psychodidae, Leishmania braziliensis physiology, Leishmaniasis, Cutaneous immunology, Saliva immunology
- Abstract
Background: Sand fly saliva has an array of pharmacological and immunomodulatory components, and immunity to saliva protects against Leishmania infection. In the present study, we have studied the immune response against Lutzomyia intermedia saliva, the main vector of Leishmania braziliensis in Brazil, and the effects of saliva pre-exposure on L. braziliensis infection employing an intradermal experimental model., Methodology/principal Findings: BALB/c mice immunized with L. intermedia salivary gland sonicate (SGS) developed a saliva-specific antibody response and a cellular immune response with presence of both IFN-gamma and IL-4. The inflammatory infiltrate observed in SGS-immunized mice was comprised of numerous polymorphonuclear and few mononuclear cells. Mice challenged with live L. braziliensis in the presence of saliva were not protected although lesion development was delayed. The inoculation site and draining lymph node showed continuous parasite replication and low IFN-gamma to IL-4 ratio, indicating that pre-exposure to L. intermedia saliva leads to modulation of the immune response. Furthermore, in an endemic area of cutaneous leishmaniasis, patients with active lesions displayed higher levels of anti-L. intermedia saliva antibodies when compared to individuals with a positive skin test result for Leishmania., Conclusion: These results show that pre-exposure to sand fly saliva plays an important role in the outcome of cutaneous leishmaniasis, in both mice and humans. They emphasize possible hurdles in the development of vaccines based on sand fly saliva and the need to identify and select the individual salivary candidates instead of using whole salivary mixture that may favor a non-protective response.
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- 2007
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22. Epidemiologic and immunologic findings for the subclinical form of Leishmania braziliensis infection.
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Follador I, Araújo C, Bacellar O, Araújo CB, Carvalho LP, Almeida RP, and Carvalho EM
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- Adult, Animals, Brazil epidemiology, Female, Humans, Intradermal Tests, Leishmaniasis, Mucocutaneous immunology, Male, Sensitivity and Specificity, Disease Outbreaks, Leishmania braziliensis, Leishmaniasis, Mucocutaneous epidemiology
- Abstract
The epidemiologic and immunologic findings for 104 subjects with subclinical Leishmania braziliensis infection were compared with those for 29 patients with cutaneous leishmaniasis (CL) from the same area of endemicity. Subjects had a positive leishmania skin test result and remained asymptomatic during the next 4 years of follow-up were considered to have subclinical infection. Patients with CL were younger, had larger-diameter indurations after skin testing, and were more likely to have positive serologic markers than were those with subclinical infection (P<.05). In subjects with subclinical infection, levels of interferon-gamma and tumor necrosis factor-alpha in lymphocyte supernatants were lower than they were in patients with CL (P<.05); however, mean interleukin-5 levels were slightly higher in patients with subclinical infection than in patients with CL. These data indicate that, unlike patients with CL, individuals who do not develop disease when infected with L. braziliensis may have the ability to modulate their immune response.
- Published
- 2002
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23. Immune responses to an inactive vaccine against American cutaneous leishmaniasis together with granulocyte-macrophage colony-stimulating factor.
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Follador I, Araujo C, Orge G, Cheng LH, de Carvalho LP, Bacellar O, Almeida RP, and Carvalho EM
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- Animals, Double-Blind Method, Humans, Hypersensitivity, Delayed etiology, Interferon-gamma biosynthesis, Interleukin-5 biosynthesis, Recombinant Proteins, Vaccines, Inactivated immunology, Adjuvants, Immunologic pharmacology, Granulocyte-Macrophage Colony-Stimulating Factor pharmacology, Leishmania mexicana immunology, Protozoan Vaccines immunology
- Abstract
The immunological response in healthy subjects to a crude leishmania antigen vaccine (Leishvacin) plus rhGM-CSF without prior Montenegro (DTH) skin testing was evaluated. Fifty-six healthy volunteers received vaccine plus either placebo or rhGM-CSF at day 0, followed by either a vaccine booster or placebo at day 21. IFN-gamma and IL-5 levels were significantly enhanced by day 21. The adjuvant group had a higher percentage of individuals with a significant response to vaccination than the corresponding placebo group. Eighty-six percent of all volunteers were DTH-positive by day 42. Leishvacin is capable of sensitizing lymphocytes from individuals not previously exposed to leishmania antigen. Use of rhGM-CSF enhanced the immune response, indicating that it may improve immunological response to the vaccine.
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- 2002
- Full Text
- View/download PDF
24. Cutaneous protothecosis: report of the second Brazilian case.
- Author
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Follador I, Bittencourt A, Duran F, and das Graças Araújo MG
- Subjects
- Aged, Brazil epidemiology, Female, Hand Dermatoses epidemiology, Hand Dermatoses pathology, Humans, Infections epidemiology, Infections microbiology, Infections pathology, Hand Dermatoses microbiology, Prototheca
- Abstract
The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a non-immunocompromised female from the state of Bahia, Brazil. This is the second case described in Brazil. Dermatological examination revealed diffusely infiltrated erythematous plaques on the flexor aspect of the right arm and forearm. The authors emphasize the pathological aspects that can lead to misdiagnosis this condition. The patient was successfully treated with fluconazole.
- Published
- 2001
- Full Text
- View/download PDF
25. [Outbreak of American cutaneous leishmaniasis in Canoa, Santo Amaro, Bahia, Brazil].
- Author
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Follador I, Araujo C, Cardoso MA, Tavares-Neto J, Barral A, Miranda JC, Bittencourt A, and Carvalho EM
- Subjects
- Adult, Animals, Brazil epidemiology, Child, Child, Preschool, Dogs, Female, Humans, Male, Disease Outbreaks, Leishmaniasis, Cutaneous epidemiology
- Abstract
An outbreak of American cutaneous leishmaniasis (ACL) was detected in the village of Canoa in 1993. A prospective observational study was outlined to determine the frequency rates and to clinically characterize the disease. A total of 555 people were followed up. There were 29 cases of ACL, 11 cases of probably previous ACL (scars) and 529 healthy individuals. Of these 529 individuals, 65 had a positive Montenegro reaction without any present or past evidence of leishmaniasis. The prevalence of ACL during the two years was 5.2% (29/555). The leishmania involved was Leishmania braziliensis and the vector, Lutzomyia intermedia. Evidence of infection was detected in dogs and horses. The high frequency of the disease among children under ten years, the similar sex distribution of cases and a component of familial aggregation suggest a peri- or intra-domiciliary transmission.
- Published
- 1999
- Full Text
- View/download PDF
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