Artigos - Dermatologia e Radioterapia - FMB

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  • ItemResenha
    New small molecules in dermatology: for the autoimmunity, inflammation and beyond
    (2023-01-01) Criado, Paulo Ricardo ; Lorenzini, Daniel ; Miot, Hélio Amante ; Bueno-Filho, Roberto ; Carneiro, Francisca Regina Oliveira ; Ianhez, Mayra ; Santo André ; Santa Casa de Misericórida de Porto Alegre ; Universidade Estadual Paulista (UNESP) ; Universidade de São Paulo (USP) ; UEPA—Belém ; Universidade Federal de Goiás (UFG)
    Objective and design: The discovery of new inflammatory pathways and the mechanism of action of inflammatory, autoimmune, genetic, and neoplastic diseases led to the development of immunologically driven drugs. We aimed to perform a narrative review regarding the rising of a new class of drugs capable of blocking important and specific intracellular signals in the maintenance of these pathologies: the small molecules. Materials/methods: A total of 114 scientific papers were enrolled in this narrative review. Results: We describe in detail the families of protein kinases—Janus Kinase (JAK), Src kinase, Syk tyrosine kinase, Mitogen-Activated Protein Kinase (MAPK), and Bruton Tyrosine Kinase (BTK)—their physiologic function and new drugs that block these pathways of intracellular signaling. We also detail the involved cytokines and the main metabolic and clinical implications of these new medications in the field of dermatology. Conclusions: Despite having lower specificity compared to specific immunobiological therapies, these new drugs are effective in a wide variety of dermatological diseases, especially diseases that had few therapeutic options, such as psoriasis, psoriatic arthritis, atopic dermatitis, alopecia areata, and vitiligo.
  • ItemResenha
    Eosinophilia and elevated IgE serum levels: a red flag: when your diagnosis is not a common atopic eczema or common allergy
    (2023-03-01) Criado, Paulo Ricardo ; Miot, Hélio Amante ; Ianhez, Mayra ; Full Researcher ; Universidade Estadual Paulista (UNESP) ; Universidade Federal de Goiás (UFG)
    Objective and design: The hallmark of type 2 inflammation is eosinophilia and/or high IgE serum levels, mostly in atopic dermatitis. Nevertheless, many dermatoses may present similar findings. Our aim is to explore the biological and clinical spectrum of cutaneous manifestations involving tissue and/or systemic eosinophilia, and distinct serum levels of IgE, where atopic dermatitis or other primary allergic eczema, not always is the definitive diagnosis. Materials/methods: A total of 37 scientific papers were enrolled in this narrative review. Results: A diagnostic approach for patients with elevated serum IgE level and a list of conditions not related to atopic dermatitis that runs through inborn errors of immunity, inflammatory disorders, lung disorders, malignancy, infections/infestations are displayed. Regarding to peripheral eosinophilia, differential diagnosis is also explored and clinical patterns of skin diseases associated with tissue eosinophilia are listed, to facilitate our diagnosis. Conclusions: We should maintain a high level of suspicion about other differential diagnosis involving eosinophilia and IgE dysregulation, especially in patients very young (when innate errors of the immunity may present) and in middle to elderly patients classified as having atopic dermatitis, due to the possibility of cutaneous hematological malignancies, paraneoplasia or autoimmune blistering diseases.
  • ItemResenha
    Lesions caused by human and domestic and wild animal bites
    (2022-01-01) Haddad Junior, Vidal ; Universidade Estadual Paulista (UNESP)
    Animal bites are a common problem in the emergency room. There are many reports of isolated cases (mainly of domestic mammals); however, texts with more comprehensive and general guidance on these kinds of bite injuries are necessary, including those caused by wild mammals, reptiles, and even fish. This review aims to update knowledge on this problem, which includes human and domestic and wild animal bites. Health teams in emergency care centers should be aware of the initial and late measures required to control this problem.
  • ItemEditorial
    Anais Brasileiros de Dermatologia: updating guidelines for authors
    (2023-01-01) Marques, Sílvio Alencar ; Roselino, Ana Maria ; Almeida, Hiram Laranjeira de ; Abbade, Luciana P. Fernandes ; Universidade Estadual Paulista (UNESP) ; Universidade de São Paulo (USP) ; Universidade Federal de Pelotas ; Universidade Católica de Pelotas
  • ItemArtigo
    Mapping of the venomous stingrays of the Potamotrygon genus in the Tietê River, São Paulo Sstate, Brazil
    (2022-01-01) Moreira, Isleide Saraiva Rocha ; Junior, Vidal Haddad ; Universidade Estadual Paulista (UNESP)
    Background: Freshwater stingrays are fish that have adapted to the rivers and lakes in South America. The expansion of the Potamotrygonidae family in the Paraná River began after the damming of the Sete Quedas Falls, reaching the mouth of the Paranapanema and Tietê rivers approximately 20 years ago via the locks of the hydroelectric power plants. They are not aggressive animals; however, they have one to four stingers on their tails covered by a venom-producing epithelium and can cause severe envenomation in fishermen and bathers if stepped on or manipulated. Methods: We conducted a descriptive, retrospective, and prospective study by monitoring the fishing of the Potamotrygon genus in the lower Tietê River, mapping the location of the rays as a fishery product of professional fishermen and/or recording images of the fish caught. Results: Sixteen stingrays of the Potamotrygon genus were mapped by monitoring fishermen's fish products in the extensive area between the municipalities of Pereira Barreto and Buritama, São Paulo state. Conclusions: The lower Tietê River is fully colonized by freshwater stingrays and this expansion likely continues upstream, reaching various sub-basins of the river. The advancement of these venomous fish in areas where they did not exist previously requires education programs and interaction with the community to avoid serious injuries in bathers and fishermen and the unreasonable extermination of the animals.
  • ItemCarta
    Lionfish envenomation on the Brazilian coast: first repor
    (2022-01-01) Haddad Junior, Vidal ; Giarrizzo, Tommaso ; Soares, Marcelo de Oliveira ; Universidade Estadual Paulista (UNESP) ; Instituto de Ciências do Mar (Labomar) ; Leibniz Center for Tropical Marine Research (ZMT)
  • ItemArtigo
    Heart Disease Knowledge Questionnaire: Psychometric Properties in Brazilian Adults
    (2022-01-01) Lima, Fernanda Maria Alves ; Jamas, Milena Temer ; Miot, Hélio Amante ; Garcia de Avila, Marla Andréia ; Universidade Estadual Paulista (UNESP)
    Background: The assessment of knowledge about cardiovascular diseases through instruments helps to identify gaps and educational needs of the target audience. Purpose: To validate and verify the psychometric properties of the Brazilian version of the Heart Disease Knowledge Questionnaire (HDKQ-BR) for adults in Brazil. Methods: Cross-sectional methodological study carried out in a Brazilian city with 300 participants. Internal consistency, temporal stability (test-retest) and convergent structural validity were verified. Item Response Theory (IRT) was used to determine parameters a (discrimination) and b (difficulty) of each item and the unidimensionality of the instrument and the differential item functioning (DIF) for sex, education and age. Results: The internal consistency of the HDKQ-BR was 0.694. The test-retest reliability was confirmed by the intraclass correlation coefficient (ICC = 0.779). According to the IRT, parameter a was between 0.176 and 1.175 and parameter b between −10.834 and 4.969. Discussion: The HDKQ-BR showed unidimensional structure and adequate psychometric performance for its application in populations with the same profile in Brazil. Translation to Health Education Practice: To assess the knowledge of an adult population about CVDs is important for improving the health literacy. The study focused on Area I of Responsibilities for Health Education Specialists (Assessment of Needs and Capacity).
  • ItemArtigo
    Bullosis diabeticorum as a differential diagnosis for limb ulcers: case report
    (2022-01-01) Grillo, Vinicius Tadeu Ramos da Silva ; Botelho, Mayra Souza ; Lange, Eloana Pasqualin ; Secanho, Murilo Sgarbi ; de Camargo, Paula Angeleli Bueno ; Miot, Hélio Amante ; Universidade Estadual Paulista (UNESP)
    Bullosis diabeticorum (BD) is an uncommon cutaneous manifestation of diabetes that can affect the upper limbs. It is characterized by spontaneous and painless non-inflammatory bloody blisters, which can progress to necrosis, requiring differential diagnosis to rule out other dermatological diseases, such as porphyria cutanea tarda, pseudoporphyria, epidermolysis bullosa acquisita, and pemphigoid, and vascular diseases, such as vasculitis, peripheral arterial disease, and Buerger’s disease, among others. In this report, we describe a 77-year-old male patient with poorly controlled diabetes and hypertension who presented with spontaneous onset of lesions on the upper limbs, initially with bullous characteristics, progressing to necrotic ulcers after spontaneous rupture. A biopsy revealed hyaline thickening of the dermal vessels and subcorneal bullae, consistent with a diagnosis of BD. After smoking cessation and optimization of glycemia control combined with topical corticosteroid therapy, the condition improved and lesions began to heal. This presentation of BD involving the upper limbs is rare, requiring differential diagnosis to rule out other cutaneous and vascular lesions.
  • ItemArtigo
    Immunological evaluation of young unvaccinated patients with Turner syndrome after COVID-19
    (2023-04-01) de Castro, Mateus V. ; Silva, Monize V.R. ; Oliveira, Luana de M. ; Gozzi-Silva, Sarah C. ; Naslavsky, Michel S. ; Scliar, Marilia O. ; Magalhães, Monize L. ; da Rocha, Katia M. ; Nunes, Kelly ; Castelli, Erick C. ; Magawa, Jhosiene Y. ; Santos, Keity S. ; Cunha-Neto, Edecio ; Sato, Maria N. ; Zatz, Mayana ; Universidade de São Paulo (USP) ; Universidade Estadual Paulista (UNESP) ; Instituto de Investigação em Imunologia - Instituto Nacional de Ciências e Tecnologia-iii-INCT
    Objectives: The X-chromosome contains the largest number of immune-related genes, which play a major role in COVID-19 symptomatology and susceptibility. Here, we had a unique opportunity to investigate, for the first time, COVID-19 outcomes in six unvaccinated young Brazilian patients with Turner syndrome (TS; 45, X0), including one case of critical illness in a child aged 10 years, to evaluate their immune response according to their genetic profile. Methods: A serological analysis of humoral immune response against SARS-CoV-2, phenotypic characterization of antiviral responses in peripheral blood mononuclear cells after stimuli, and the production of cytotoxic cytokines of T lymphocytes and natural killer cells were performed in blood samples collected from the patients with TS during the convalescence period. Whole exome sequencing was also performed. Results: Our volunteers with TS showed a delayed or insufficient humoral immune response to SARS-CoV-2 (particularly immunoglobulin G) and a decrease in interferon-γ production by cluster of differentiation (CD)4+ and CD8+ T lymphocytes after stimulation with toll-like receptors 7/8 agonists. In contrast, we observed a higher cytotoxic activity in the volunteers with TS than the volunteers without TS after phorbol myristate acetate/ionomycin stimulation, particularly granzyme B and perforin by CD8+ and natural killer cells. Interestingly, two volunteers with TS carry rare genetic variants in genes that regulate type I and III interferon immunity. Conclusion: Following previous reports in the literature for other conditions, our data showed that patients with TS may have an impaired immune response against SARS-CoV-2. Furthermore, other medical conditions associated with TS could make them more vulnerable to COVID-19.
  • ItemArtigo
    Sporothrix pathogenic clade: Molecular analysis of animal and human clinical isolates
    (2023-01-01) Ribeiro-Marques, Mariela Domiciano ; Maschio-Lima, Taiza ; Lemes, Thiago Henrique ; Siqueira, João Paulo Zen ; Brizzotti-Mazuchi, Natália Seron ; Caetano, Maicon Henrique ; Almeida, Bianca Gottardo ; Mozaner, Leticia Queiroz ; Monteiro, Ruan Campos ; Camargo, Zoilo Pires ; Rodrigues, Anderson Messias ; Gottardo De Almeida, Margarete Teresa ; São José Do Rio Preto School of Medicine (FAMERP) ; Universidade Estadual Paulista (UNESP) ; Universidade de São Paulo (USP)
    Sporotrichosis is a subcutaneous mycosis that affects animals and humans. Varying in severity, occurrences range from local lesions to systemic involvement. It is caused by thermodimorphic and saprobic fungi from the Sporothrix pathogenic clade. This study aimed to identify the species and the sexual idiomorph distribution patterns responsible for diagnosed cases of sporotrichosis in São José do Rio Preto, Brazil. We included 188 isolates of Sporothrix sp. from feline lesions and 27 of human origin, which underwent molecular identification and genotyping for mating-type MAT1-1 and MAT1-2. The results showed that Sporothrix brasiliensis is the prevalent species in feline sporotrichosis outbreaks with the overwhelming presence of a single mating-type, MAT1-2 (P <.0001), suggesting a prevalently clonal form of spread. Morphological analyses did not discriminate among cryptic species in the genus Sporothrix, and molecular identification was essential for the correct identification of the species responsible for the observed cases of sporotrichosis. Distribution analyses of MAT1-2 isolates support the hypothesis of unidirectional migration from the current epidemics in São Paulo and Rio de Janeiro to the municipality of São José do Rio Preto.
  • ItemArtigo
    Primary Cutaneous Cryptococcosis Caused by Cryptococcus gatti in an Elderly Patient
    (2022-09-01) Belda, Walter ; Casolato, Ana T. S. ; Luppi, Juliana B. ; Passero, Luiz Felipe D. ; Criado, Paulo R. ; Universidade de São Paulo (USP) ; Universidade Estadual Paulista (UNESP) ; Fundação Universitária do ABC (FUABC)
    According to the spread of Cryptococcus sp., fungal infections can be classified as primary or secondary. In primary cutaneous cryptococcosis, the fungi are restricted to the skin of the patients, without systemic involvement. The incidence of primary cutaneous cryptococcosis is high in patients with immunosuppression, and this type of infection is rarely observed in patients who are immunocompetent. In the present case report, a patient who is immunocompetent and has systemic comorbidity reported that, after skin trauma, ulcerovegetative lesions appeared in the right upper arm; the etiologic agent was identified as Cryptococcus gatti, serotype B. The cutaneous lesions healed completely after 5 months of fluconazole treatment.
  • ItemErrata
    Sem título
    (2022-09-01) Lesbon, Jéssika Cristina Chagas ; Poleti, Mirele Daiana ; de Mattos Oliveira, Elisângela Chicaroni ; Patané, José Salvatore Leister ; Clemente, Luan Gaspar ; Viala, Vincent Louis ; Ribeiro, Gabriela ; Giovanetti, Marta ; de Alcantara, Luiz Carlos Junior ; Teixeira, Olivia ; Nonato, Maria Cristina ; de Lima, Loyze Paola Oliveira ; Martins, Antonio Jorge ; dos Santos Barros, Claudia Renata ; Marqueze, Elaine Cristina ; de Souza Todão Bernardino, Jardelina ; Moretti, Debora Botequio ; Brassaloti, Ricardo Augusto ; de Lello Rocha Campos Cassano, Raquel ; Mariani, Pilar Drummond Sampaio Correa ; Slavov, Svetoslav Nanev ; dos Santos, Rafael Bezerra ; Rodrigues, Evandra Strazza ; Santos, Elaine Vieira ; Borges, Josiane Serrano ; de La Roque, Debora Glenda Lima ; Kitajima, Joao Paulo ; Santos, Bibiana ; Assato, Patricia Akemi ; da Silva da Costa, Felipe Allan ; Banho, Cecilia Artico ; Sacchetto, Livia ; Moraes, Marilia Mazzi ; Palmieri, Melissa ; da Silva, Fabiana Erica Vilanova ; Grotto, Rejane Maria Tommasini ; Souza-Neto, Jayme A. ; Nogueira, Mauricio Lacerda ; Coutinho, Luiz Lehman ; Calado, Rodrigo Tocantins ; Neto, Raul Machado ; Covas, Dimas Tadeu ; Kashima, Simone ; Elias, Maria Carolina ; Sampaio, Sandra Coccuzzo ; Fukumasu, Heidge ; Universidade de São Paulo (USP) ; Butantan Institute ; FIOCRUZ ; Universidade Federal de Minas Gerais (UFMG) ; NGS Soluções Genômicas ; Mendelics Genomic Analysis ; Universidade Estadual Paulista (UNESP) ; Faculdade de Medicina de São José do Rio Preto ; Coordenação de Vigilância em Saúde—Secretaria Municipal da Saúde ; Municipal Health Department
    The authors hereby request the inclusion of two authors (Olivia Teixeira and Maria Cristina Nonato) in the recently published article in Viruses entitled “Nucleocapsid (N) gene mutations of SARS-CoV-2 can affect real-time RT-PCR diagnostic and impact false-negative results” [1].
  • ItemResenha
    JAK-STAT pathway inhibitors in dermatology
    (2023-01-01) Miot, Hélio Amante ; Criado, Paulo Ricardo ; de Castro, Caio César Silva ; Ianhez, Mayra ; Talhari, Carolina ; Ramos, Paulo Müller ; Universidade Estadual Paulista (UNESP) ; Centro Universitário Faculdade de Medicina do ABC ; Faculdade de Ciências Médicas de Santos ; Hospital de Dermatologia Sanitária do Paraná ; Pontifícia Universidade Católica do Paraná ; Universidade Federal de Goiás (UFG) ; Universidade do Estado do Amazonas
    The JAK-STAT signaling pathway mediates important cellular processes such as immune response, carcinogenesis, cell differentiation, division and death. Therefore, drugs that interfere with different JAK-STAT signaling patterns have potential indications for various medical conditions. The main dermatological targets of JAK-STAT pathway inhibitors are inflammatory or autoimmune diseases such as psoriasis, vitiligo, atopic dermatitis and alopecia areata; however, several dermatoses are under investigation to expand this list of indications. As JAK-STAT pathway inhibitors should gradually occupy a relevant space in dermatological prescriptions, this review presents the main available drugs, their immunological effects, and their pharmacological characteristics, related to clinical efficacy and safety, aiming to validate the best dermatological practice.
  • ItemCarta
    Prevalence of immune-mediated inner ear disease in non-segmental vitiligo: A cross-sectional study
    (2023-07-01) Marchioro, Helena Zenedin ; de Castro, Caio César Silva ; Chiesorin, Aline Salete Turatti ; Bindi, Elaine Weiss ; Jiacomini, Isabella Gizzi ; Miot, Hélio Amante ; Santa Casa Hospital ; Pontifícia Universidade Católica do Paraná ; Universidade Federal do Paraná (UFPR) ; Universidade Estadual Paulista (UNESP)
    Background: Sensorineural hearing loss (SNHL) is associated with non-segmental vitiligo (NSV); however, the aetiology of SNHL has not been explored. The concomitance of autoimmune disease in vitiligo patients demands the investigation of immune-mediated inner ear disease (IMIED) as a cause of SNHL in NSV. The anti-Hsp70 antibody is a serological marker of IMIED, which may help in the early diagnosis of this disease. Objective: To evaluate the prevalence of IMIED in NSV patients. Methods: Cross-sectional study involving NSV adult patients and a control group, evaluated through audiometry and serological dosage of the anti-Hsp70 antibody. Results: In total, 112 cases and 23 controls were evaluated. Bilateral SNHL was found in 28 (25.0%; 95%CI 17.9%–32.1%) patients and in 1 (4.3%) control (p = 0.019). Six cases (5.4%; 95%CI 2.7%–8.0%) presented bilateral SNHL of unexplained aetiology, and anti-Hsp70 antibody positivity, fulfilling the diagnostic criteria for IMIED. No controls met the diagnostic criteria for IMIED. Serum anti-Hsp70 antibodies were higher in cases with IMIED: median 220.9 vs. 85.1 ng/ml (p = 0.001). Conclusion: The prevalence of IMIED is remarkable in NSV adult patients.
  • ItemArtigo
    Intestinal microbiome characterization of adult Brazilian men with psoriasis compared to omnivore and vegetarian controls
    (2023-01-01) Polo, Tatiana Cristina Figueira ; Lai, Mariana Righetto de Ré ; Miot, Luciane Donida Bartoli ; Bento, Giovana Fernanda Cosi ; Silva, Márcia Guimarães da ; Marques, Silvio Alencar ; Miot, Hélio Amante ; Universidade Estadual Paulista (UNESP)
    Background: Psoriasis is a chronic inflammatory disease associated with systemic inflammation and comorbidities. Changes in the composition of the intestinal microbiome are involved in the pathogenesis of inflammatory diseases and metabolic syndrome. Characterizing the intestinal microbiome of patients with psoriasis may be relevant for the understanding of its clinical course and comorbidity prevention. Objective: To characterize the intestinal microbiome of men with psoriasis compared to omnivore and vegetarian controls (without psoriasis). Method: Cross-sectional study of 42 adult males: 21 omnivores with psoriasis; and controls: 14 omnivores and 7 vegetarian individuals. The characterization of the intestinal microbiome was performed by metagenomic analysis. Serum levels of lipopolysaccharide-binding protein (LPB) and C-reactive protein (CRP) were evaluated. Results: The groups differed from each other regarding nutritional aspects and microbiome; individuals with psoriasis had a higher consumption of protein and lower consumption of fibers. Levels of LPB, CRP, and the Firmicutes/Bacteroidetes ratio were higher in the group with psoriasis than in the vegetarian group (p < 0.05). The genera Prevotella, Mogibacterium, Dorea, Bifidobacterium and Coprococcus, differed in the group with psoriasis compared to vegetarians; the genera Mogibacterium, Collinsella and Desulfovibrio differed from omnivores. A microbiome pattern linked to psoriasis (plsPSO) was identified, which was associated with higher LPB levels (rho = 0.39; p = 0.02), and lower dietary fiber intake (rho = −0.71; p < 0.01). Study limitations: Only adult men were evaluated. Conclusion: A difference was identified in the intestinal microbiome of adult men with psoriasis when compared to healthy omnivores and vegetarian controls. The identified microbiome pattern was correlated with dietary fiber intake and serum levels of LPB.
  • ItemCarta
    Gut microbiome diversity and serum levels of lipopolysaccharide-bound protein (LPB) in men with psoriasis under different systemic therapies
    (2023-01-01) de Ré Lai, Mariana Righetto ; Polo, Tatiana Cristina Figueira ; Miot, Luciane Donida Bartoli ; Bento, Giovana Fernanda Cosi ; da Silva, Márcia Guimaraes ; Miot, Hélio Amante ; Universidade Estadual Paulista (UNESP)
  • ItemCarta
    On the recurrence rate of cutaneous tumors treated exclusively by micrographic surgery
    (2023-05-01) Garbers, Luiz Eduardo Fabrício de Melo ; Miola, Ana Carolina ; Kopke, Luis Fernando Figueiredo ; Miot, Hélio Amante ; Universidade Estadual Paulista (UNESP) ; Universidade Federal de Santa Catarina (UFSC)
  • ItemCarta
    Frontal fibrosing alopecia associated with lichen planus pigmentosus: A multicentre retrospective descriptive analytical study of 104 patients
    (2023-01-01) Xavier de Brito, Flavia Oliveira ; Cortez de Almeida, Rita Fernanda ; Machado, Carla Jorge ; Lemes, Luciana Rodino ; Donda, Andre Luiz Vairo ; Blanco, Aline ; Silveira, Aline Lucy Galavotti ; Munck, Andreia ; Lima, Caren dos Santos ; Cotrim Canela, Carolina Porto ; Fechine, Carolina Oliveira Costa ; Obadia, Daniel Lago ; Pinto, Giselle Martins ; Alves, Lorena Dourado ; Dias, Maria Fernanda Reis Gavazzoni ; Benez, Marcela ; Rigatti, Marcelo ; El Kadi, Nadia ; Kakizaki, Priscila ; Minotto, Renan ; Frattini, Sidney ; Müller Ramos, Paulo ; Melo, Daniel Fernandes ; Universidade do Estado do Rio de Janeiro (UERJ) ; Universidade Federal de Minas Gerais (UFMG) ; Hospital Universitário Maria Aparecida Pedrossian ; Hospital Naval Marcilio Dias ; Mogi das Cruzes University – UMC ; University of State of Pará – UEPA ; University Center of Pará – CESUPA ; Private Practice ; Universidade de São Paulo (USP) ; Federal University of Goias – UFG ; Federal Fluminense University – UFF ; Universidade Federal de Santa Catarina (UFSC) ; Hospital do Servidor Público Municipal de São Paulo ; Hospital Santa Casa de Porto Alegre ; Universidade Estadual Paulista (UNESP)
  • ItemCarta
    The (one-year) prevalence of atopic dermatitis in Brazil: A population-based telephone survey
    (2023-01-01) Miot, Hélio Amante ; Aoki, Valeria ; Orfali, Raquel Leão ; Solé, Dirceu ; Mallozi, Márcia Carvalho ; Rodrigues, Tatiane C. ; Silverberg, Jonathan I. ; Universidade Estadual Paulista (UNESP) ; Universidade de São Paulo (USP) ; ABC Medical School ; AbbVie ; George Washington University School of Medicine and Health Sciences
  • ItemArtigo
    High prevalence of olfactory impairment among leprosy patients: A cross-sectional study
    (2023-04-01) Kondo, Rogério Nabor ; de Araújo, Milene Cripa Pizatto ; Ramos, Paulo Muller ; Miot, Hélio Amante ; Fornazieri, Marco Aurélio ; Universidade Estadual de Londrina (UEL) ; Universidade Estadual Paulista (UNESP) ; Pontifícia Universidade Católica do Paraná ; Universidade de São Paulo (USP) ; University of Pennsylvania
    Background The effect of leprosy on the sense of smell is not yet fully established. Studies that have relied only on patients’ perceptions may have under-or over-estimated the change in smell perception. A validated and psychophysical method is necessary to avoid these errors in assessment. Objectives This study aimed to validate the existence of olfactory involvement in leprosy patients. Methods A cross-sectional, controlled study was conducted, in which individuals with leprosy (exposed individuals) and individuals without leprosy (control patients) were recruited. For each exposed individual, we selected two control patients. A total of 108 patients (72 control patients and 36 exposed individuals) with no history of infection with the new coronavirus (COVID-19) took the University of Pennsylvania Smell Identification Test (UPSIT). Results Most exposed individuals had olfactory dysfunction [n = 33, 91.7% (CI 95%: 77.5%–98.3%)] when compared with the control patients [n = 28, 38.9% (CI 95%: 27.6%-51.1%)], but only two (5.6%) had olfactory complaints. The olfactory function was significantly worse among exposed individuals [UPSIT leprosy = 25.2 (CI 95%: 23.1–27.3) when compared with the UPSIT control patients = 34.1 (CI 95%: 33.0–35.3); p<0.001]. The risk of olfactory loss was higher among the exposed individuals [OR: 19.5 (CI 95%: 5.18–105.70; p < 0.001)]. Conclusions Olfactory dysfunction was highly prevalent among exposed individuals, although they had little or no self-knowledge of the disorder. The results show that it is important to assess the sense of smell in exposed individuals.