Evaluation of nutritional status in patients with endemic pemphigus foliaceus

A avaliação nutricional foi realizada em dezesseis doentes portadores de pênfigo foliáceo endêmico, sendo dez portadores da forma localizada da doença (Grupo G1) e seis portadores da forma disseminada da mesma (Grupo G2). Foram realizadas avaliações antropométricas (peso, altura, índice de Quetelét, prega cutânea tricipital, prega cutânea subescapular, circunferência braquial, circunferência muscular do braço, área do braço, área muscular do braço, área adiposa do braço) e laboratorial (eletroforese de proteínas séricas). Quanto aos parâmetros antropométricos, observaram-se as seguintes alterações: a circunferência do braço, área do braço, e área muscular do braço mostraram valores mais baixos nos doentes do grupo G2 que nos do grupo G1. O peso e a circunferência muscular do braço, por sua vez, mostraram tendência a valores mais baixos nos doentes do grupo G2 que nos do grupo G1. A eletroforese de proteínas revelou valores de albumina diminuídos em ambos os grupos, e menores nos doentes do grupo G2. Quanto às demais frações, com exceção das beta globulinas, não foram evidenciadas alterações. A análise global dos resultados permite concluir que os doentes com pênfigo foliáceo endêmico apresentam um quadro de desnutrição proteica, mas não calórica. Esta desnutrição mostrou-se mais acentuada no pênfigo foliáceo disseminado.

Cell and humoral immunity in endemic pemphigus foliaceus

Foram avaliados dezesseis doentes portadores de pênfigo foliáceo endêmico, dez com a forma localizada da doença (Grupo G1) e seis com a forma disseminada (Grupo G2), com os objetivos de correlacionar o quadro clínico e laboratorial desses pacientes com o perfil imunológico dos mesmos, e verificar a relação dos títulos dos anticorpos antiepiderme circulantes, identificados pela imunofluorescência indireta, com intensidade da lesão e com a evolução das lesões em tratamento. Foram realizados: hemograma completo, quantificação de subpopulação de células mononucleares por anticorpos monoclonais e estudo da transformação blástica de linfócitos e quantificação de anticorpos circulantes por meio da reação de imunofluorescência indireta. Observou-se leucocitose principalmente no grupo G2, diminuição dos valores relativos das subpopulações de linfócitos CD3+ e CD4+ e tendência à diminuição dos valores relativos da subpopulação CD8+ nos doentes (Grupos G1 e G2). Os índices de transformação blástica de linfócitos frente à fitohemaglutinina revelaram níveis mais elevados nos doentes (Grupos G1 + G2), que nos controles. A reação de imunofluorescência indireta foi positiva em 100% dos doentes do grupo G2 e em 80% do grupo G1 A mediana dos valores dos títulos foi maior no grupo G2, quando comparado com o grupo G1. A análise global dos resultados permite concluir que a imunidade celular está preservada, e que existe uma relação entre os títulos de anticorpos obtidos à reação de imunofluorescência indireta e extensão da lesão cutânea.

Low-level laser therapy on the treatment of oral and cutaneous pemphigus vulgaris: case report

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially is manifested by painful intraoral erosions and ulcers which spread to other mucosa and the skin, generally more than 5 months after oral lesion manifestation. The treatment consists of prednisone alone or in combination with an immunosuppressive agent, and the clinical response is perceived within 2 to 4 weeks. Low-level laser therapy has been effective in accelerating the healing of injured tissue, thus inducing cell proliferation and increasing ATP, nucleic acid, and collagen synthesis. We reported two cases of pemphigus vulgaris that received systemic treatment associated with low-level laser therapy for oral and cutaneous lesions. We observed prompt analgesic effect in oral lesions and accelerated healing of oral and cutaneous wounds. Therefore, the present report suggests LLLT as a noninvasive technique that should be considered as an adjuvant therapy in oral and skin disorders in patients with PV.

Gingival lesions diagnosed as pemphigus vulgaris in an adolescent. Case report

Desquamative gingivitis (DG) is a fairly common disorder in which the gingivae show chronic desquamation. Originally considered to be related to hormonal changes at menopause, since many of the patients are middle-aged women, DG is now recognized to be mainly a manifestation of a number of disorders ranging from vesiculobullous diseases to adverse reactions to a variety of chemicals or allergens. Desquamative gingivitis can be an important early clinical manifestation of serious systemic diseases such as pemphigus vulgaris. The authors present a case that illustrates the importance of a specific diagnosis in patients with desquamative gingival lesions previously treated for 6 months as classical gingivitis. Gingival biopsy showed histologic patterns typical of pemphigus vulgaris. The patient was treated with systemic and topical corticosteroids in association with miconazole the patient is now under control with low-close systemic corticosteroids. Proper recognition of lesions in the oral mucosa leads, in several situations, to an early diagnosis of a systemic disease.

Pemphigus vulgaris in adolescence: a case report

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Pênfigo foliáceo em eqüino: relato de caso

Diagnosticou-se pênfigo foliáceo em um eqüino macho, castrado, quatro anos de idade da raça Árabe apresentando dermatite generalizada caracterizada por placas escamo-crostosas e presença de dermatite pustular acantolítica subcorneal.

Incidência das dermatopatias auto-imunes em cães e gatos e estudo retrospectivo de 40 casos de lupus eritematoso discóide atendidos no serviço de dermatologia da Faculdade de Medicina Veterinária e Zootecnia da UNESP – Botucatu

The objectives of this study were to do a survey of the autoimmune skin diseases and update the records regarding the occurrence of discoid lupus erythematosus in canine and feline populations attended at the Dermatology Service of the College of Veterinary Medicine and Animal Science of UNESP - Botucatu, including species, gender, breed, age, location and characteristic of the lesions. Results have shown that the order of occurrence, regarding the number of cases of autoimmune skin diseases in the animals attended by the Dermatology Service in the period from 1988 to 2007 was: discoid lupus erythematosus, pemphigus folliaceus, uveo-dermatologic syndrome, pemphigus vulgaris, systemic lupus erythematosus, necrolytic migratory erythema, multiforme erythema and plasmacytic pododermatitis. All the animals with discoid lupus erythematosus were dogs and most of them were mongrel females. More frequently breeds affected by discoid lupus erythematosus were german shepherd and akita and the mean age was 56 months. Most lesions were located in nasal planum, narines and periocular area and were characterized by crusting, depigmentation and erythema.

Clinicopathological analysis of oral mucous autoimmune disease: A 27-year study

Objectives: The aim of the present study was to analyze the main clinical and histopathological features of autoimmune diseases with oral manifestations such as oral lichen planus (OLP); mucous membrane pemphigoid (MMP); pemphigus vulgaris (PV) and erythema multiforme (EM). Study design: Retrospective review of 5770 files from the Oral Pathology Laboratory of Sao Jose dos Campos Dental School, São Paulo State University (UNESP) comprising a 27- year period from 1974 to 2000.Results: The cases accounted for 64 (1.10%) of 5770 anatomopathological examinations performed over the study period. Among the autoimmune diseases diagnosed, 49 (76.56%) were OLP, 6 (9.37%) were MMP, 5 (7.82%) were em and 4 (6.25%) were PV. Descriptive statistical analysis was used.Conclusion: The initial manifestations of most autoimmune diseases occur in the oral mucosa. An earlier diagnosis and proper therapeutic protocol will delay the dissemination of the lesions, thus greatly contributing to a better prognosis and quality of life of the patient.

Evaluation of Staining Methods for Cytologic Diagnosis of Oral Lesions

ObjectiveTo compare the efficacy of Papanicolaou, hematoxylin-eosin (H-E), Leishman and periodic acid-Schiff (PAS) staining for Cytologic diagnosis of oral lesions.Study DesignPatients from the Discipline of Stomatology, Sao Jose dos Campos Dental School, from the wards of Hospital Heliopolis and from the dentistry outpatient clinic of the University Hospital, University of São Paulo Medical School, with the following diseases, were selected: erythematous candidiasis (n = 9), pseudomembranous candidiasis (n = 10), squamous cell carcinoma In = 19), herpes simplex (n = 8), paracoccidioidomycosis In = 8) and pemphigus vulgaris (n = 1).ResultsThe different staining methods were compared regarding the quality of definition of cytoplasmic and nuclear morphologic characteristics and the identification of bacteria, fungi, inflammatory cells and secretions. Papanicolaou and H-E staining were considered better methods. In cases of fungal infections, PAS staining is useful and should be applied as a complementary method.ConclusionWithin the limitations of this study, it can be concluded that the cytologic diagnosis of oral lesions along with different staining methods is a useful tool for oral diagnosis. (Acta Cytol 2008;52:697-701)

Caso para diagnóstico

Apresenta-se um caso de bullosis diabeticorum, doença rara associada ao diabetes mellitus crônico e complicações como a neuropatia ou nefropatia. As bolhas são tensas e grandes, com pouca inflamação circundante e localização acral, regredindo espontaneamente em cerca de três semanas. O exame histopatológico é inespecífico, e o diagnóstico diferencial deve ser feito com a epidermólise bolhosa, os pênfigos, o penfigóide bolhoso, queimaduras e erisipelas bolhosas.

Penfigo foliaceo no Hospital das Clinicas da Faculdade de Medicina de Botucatu, SP

BACKGROUND - Pemphigus foliaceus is an autoimmune bullous disease that is endemic in Brazil and in other South American countries such as Paraguay, Bolivia, Peru and Colombia. OBJECTIVES - To compare the observed clinical and epidemiological data with those referred in the literature. METHOD - Retrospective study in patients with pemphigus foliaceus admitted to and treated at University Hospital of the School of Medicine of Botucatu, SP, Brazil, from 1976 to 1993, analyzing the following variables: age, sex, race, origin and onset of disease. RESULTS - From 1976 to 1993, 63 patients were treated, with an average of 3.7 cases/year. Patients within the age range of 20 to 60 years old were the most affected. Most of the patients were white, females being slightly more affected than males. The majority of male patients were rural workers. Some towns presented higher incidence of cases. Most of the patients from rural areas became sick mainly in summer and in autumn. Occurrence of similar cases was observed in blood-related family members and neighbors. CONCLUSIONS - Clinical and epidemiological data were similar to those referred in the literature.

Dermatoses bolhosas auto-imunes

Autoimmune bullous dermatoses are diseases in which blisters and vesicles are the primary and fundamental types of skin lesion. Their classification is based on the location of the blister: intraepidermal and subepidermal. Patients produce autoantibodies against self-specific structures of the skin detectable by immunofluorescence techniques, immunoblotting and ELISA. Recent advances in molecular and cellular biology have brought to knowledge these self-antigens, against which patients are sensitized, and which are found in epidermis or in the dermo-epidermal junction. These are low incidence, but high morbidity diseases that may be fatal. The aim of this article is to review and describe the progress of four autoimmune vesiculobullous disorders: endemic pemphigus foliaceous (wild fire), pemphigus vulgaris, bullous pemphigoid and dermatitis herpetiformis. ©2009 by Anais Brasileiros de Dermatologia.

Fogo selvagem, alma domada: a doença e o Hospital do Pênfigo de Uberaba - história e psicografia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prevalência e aspectos clínicos de doenças gengivais de origem imune e influência da placa bacteriana na melhora dos sinais e sintomas de lesões gengivais de líquen plano bucal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)