Jane Tomimori

Leprosy Reversal Reaction as Immune Reconstitution Inflammatory Syndrome in Patients with AIDS

We report 2 instances in which reactional borderline leprosy manifested itself as an immune reconstitution phenomenon in patients with acquired immunodeficiency syndrome. We discuss the clinical, laboratory-based, histopathologic, and immunohistochemical characteristics of both patients. Furthermore, we review similar reports from the literature.

Infecção pelo papilomavírus humano: etiopatogenia, biologia molecular e manifestações clínicas

Human papillomavirus (HPV) is a DNA virus that presents tropism for epithelial cells, causing infections of the skin and mucous membranes. Replication of HPV occurs in the nuclei of squamous cells and its life cycle is directly related to the differentiation program of the host cell. To date, nearly 100 different types of HPV have been characterized and there is a large number of other types that have not been sequenced yet. Besides being responsible for benign lesions of the skin and mucous membranes, HPV is also involved in the development of various mucocutaneous tumors: Bowens disease, non-melanoma skin cancers and genital carcinomas. This review discusses the characteristics of HPV, malignant and benign mucous and skin manifestations caused by HPV, besides the main methods of detection and typing of the virus.

Treatment of subcutaneous phaeohyphomycosis and prospective follow-up of 17 kidney transplant recipients

BACKGROUND Subcutaneous phaeohyphomycosis in solid organ recipients may have an adverse outcome. OBJECTIVE We sought to describe the disease course, treatment, and outcome of allograft function in kidney transplant recipients with phaeohyphomycosis. METHODS Seventeen patients were followed for a mean period of 25.4 months to analyze the clinical response to treatment. RESULTS There was no treatment failure or relapsing disease among 12 patients who completed treatment. Two patients were still in treatment with disease remission. One patient discontinued the study during treatment with partial remission, one died after finishing treatment with disease remission, and one was dropped from the study because contact was lost. Immunosuppressive regimens were not changed. Two of 17 patients had a significant reduction in allograft function. LIMITATIONS The follow-up time was short and the number of patients was small. CONCLUSIONS The outcome of phaeohyphomycosis in kidney transplant recipients was favorable with minimal impact on renal allograft function.

Stress, immunity and skin collagen integrity: Evidence from animal models and clinical conditions

The skin is the largest organ of the human body and plays a major role in maintaining homeostasis and protection. As the main component of skin, collagen has a key role in providing integrity and elasticity to this organ. Several factors, including autoimmune disease, aging, and stress, can change the quantity and integrity of skin collagen. These factors impair collagen quality and consequently affect skin function. Stress seems to affect the integrity of skin collagen through glucocorticoid-mediated processes that alter its synthesis and degradation. Glucocorticoids also affect skin quality through modulation of the immune system. This review will briefly present comprehensive data from both animal and human studies delineating processes that modulate alterations in collagen in general, and will treat in more detail the consequences of stress on skin collagen.

Can poor sleep affect skin integrity

Modern society has reported a decline in sleep time in the recent decades. This reduction can increase the morbidity and mortality of several diseases and leads to an immunosuppressive state. The skin is the largest organ in the human body and collagen, its main component, has a key role in the structure and integrity of the organism. The entire sequence of events necessary during collagen formation can be affected by endogenous and exogenous factors. A variety of studies in the literature have shown that sleep plays a role in restoring immune system function and that changes in the immune response may affect collagen production. Several studies of prolonged sleep deprivation suggest a break in skin barrier function and mucous membranes. In fact, the reduction of sleep time affects the composition and integrity of various systems. Thus, we hypothesized that lack of sleep as well as other types of stress can impair skin integrity.

The bidirectional interactions between psoriasis and obstructive sleep apnea

Psoriasis is a chronic inflammatory skin disorder which can impair general routine activities and has been closely related to poor quality of life. Pruritus and scratching are frequently observed, occurring mainly during sleep and precipitating nighttime arousals. Indeed, sleep quality has been shown to be negatively affected in psoriatic patients, in a close relationship with stress exposure and immune response. Although psoriasis is known to impair sleep, leading to insomnia, its association with obstructive sleep apnea (OSA) is controversial. Similarly, OSA is considered a multifactorial inflammatory disease, characterized by intermittent hypoxia, sleep fragmentation and autonomic dysfunction, with important outcomes on the cardiovascular and metabolic systems. Importantly, immunological activities and pro‐inflammatory cytokines play a prominent role in both OSA and psoriasis. Currently it is not clear whether OSA is a risk factor for psoriasis development or if psoriasis is a possible predictor of OSA. Thus, our main purpose is to provide an overview of this intriguing relationship and show the current link between psoriasis and OSA in a bidirectional relationship.

Acne-specific quality of life questionnaire (Acne-QoL): translation, cultural adaptation and validation into Brazilian-Portuguese language

BACKGROUND many studies about the psychosocial impact of acne have been reported in international medical literature describing quality of life as a relevant clinical outcome. It is well known that the patients perception about the disease may be different from the physicians evaluation. Therefore, it is important to use validated instruments that turn the patients subjective opinion into objective information. OBJECTIVES to translate into Brazilian-Portuguese language and to culturally adapt a quality of life questionnaire, the Acne-Specific Quality of Life Questionnaire (Acne-QoL), as well as to evaluate its reliability and validity. METHODS measurement properties were assessed: 1) validity: comparison between severity and Acne-QoL domain scores, correlations between acne duration and Acne-QoL domain scores, and correlation between Acne-QoL domain scores and SF-36 components; 2) internal consistency: Cronbachs α coefficient; 3) test-retest reproducibility: intraclass correlation coefficient and Wilcoxon test. RESULTS Eighty subjects with a mean age of 20.5 ± 4.8 years presenting mild (33.8%), moderate (36.2%) and severe (30%) facial acne were enrolled. Acne-QoL domain scores were similar among the different acne severity groups except for role-social domain. Subjects with shorter acne duration presented significant higher scores. Acne-QoL domains showed significant correlations, both between themselves and with SF-36 role-social and mental health components. Internal consistency (0.925-0.952) and test-retest reproducibility were considered acceptable (0.768-0.836). CONCLUSIONS the Brazilian-Portuguese version of the Acne-QoL is a reliable and valid satisfactory outcome measure to be used in facial acne studies.

HLA alleles in Brazilian patients with fissured tongue.

Background  Fissured tongue (FT) is a clinical condition manifested by numerous little furrows on the tongue’s surface. Previously, the authors observed an association with HLA‐C×06 in psoriasis (PS) and benign migratory glossitis (BMG); however, HLA‐C was not surveyed in FT.

Pesquisa de anticorpos anti PGL-I através de ELISA em tatus selvagens do Brasil

Armadillos have been involved in leprosy transmission and are considered a source of Mycobacterium leprae in numerous reports. Clinicians from certain areas of the USA consider contact with armadillos a risk factor for leprosy. However, there is a challenge associated with the role of wild armadillos perpetuating human leprosy in the American Continent. The presence of anti-PGL-I antibodies was investigated in wild nine-banded armadillos from leprosy-endemic areas in State of Espirito Santo, Brazil, by ELISA performed on serum samples from 47 armadillos. Positive ELISA was obtained from 5 (10.6%) armadillos. Infected armadillos may play some role in leprosy transmission, disseminating bacilli in the environment, perhaps making it more difficult to interrupt transmission and reduce the number of new leprosy cases. ELISA is an efficient tool for seroepidemiological investigations of Mycobacterium leprae in armadillos.

Environmental factors in benign migratory glossitis and psoriasis: Retrospective study of the association of emotional stress and alcohol and tobacco consumption with benign migratory glossitis and cutaneous psoriasis

The association between benign migratory glossitis (BMG) and psoriasis (PS) has been reported in the literature.