Gunter HANS-FILHO - Academia.edu (original) (raw)

Papers by Gunter HANS-FILHO

PubMed, Jun 12, 2013

The epidermal naevus syndrome (ENS) is a sporadic condition characterized by congenital epidermal... more The epidermal naevus syndrome (ENS) is a sporadic condition characterized by congenital epidermal naevi associated with anomalies in other organ systems, most commonly the central nervous system and skeleton. We report a case of ENS presenting hypophosphataemic rickets resistant to traditional therapeutic agents.

Journal of Investigative Dermatology, May 1, 2019

International Journal of Dermatology, Aug 28, 2015

Archives of Dermatology, Jun 1, 2009

Background: Macular and lichen amyloidosis are clinical variants of primary localized cutaneous a... more Background: Macular and lichen amyloidosis are clinical variants of primary localized cutaneous amyloidosis (PLCA). Most cases are sporadic, but approximately 10% of cases may be familial. To our knowledge, the clinicopathologic and molecular features of such pedigrees, however, have not been studied in detail. Observations: We assessed 2 Brazilian families with either lichen-type (family 1 had 14 affected subjects) or macular-type (family 2 had 7 affected subjects) PLCA. Typically, in both pedigrees, the onset of symptoms was around puberty, and pruritus usually began on the lower legs. Findings from lesional skin biopsy samples from both families showed thioflavin T-positive material in the pap-illary dermis, which was more prominent in the lichen phenotype in family 1. Spontaneous improvement occurred in 3 subjects (from both families) after age 25 years. All affected individuals in family 1 had a heterozygous missense mutation in the OSMR gene (p.I691T), but no pathogenic mutation in OSMR was found in family 2. Conclusions: Familial PLCA shows autosomal dominant inheritance, but there is clinical and genetic heterogeneity and variable clinical penetrance. Demonstration of mutations in the OSMR gene provides new insight into mechanisms of itch and apoptosis in human skin.

The rapid evolution of telecommunication resources signals the need for innovation in the constru... more The rapid evolution of telecommunication resources signals the need for innovation in the construction of knowledge. Today, teaching is a challenging task because study materials must spark the interest of learners amongst the highly technological milieu enveloping their lives. Team-based learning (TBL), a student-centered strategy for group learning, has been shown to provide greater retention of knowledge than traditional education methods. Nonetheless, few studies have addressed the use of audiovisual tools in TBL. The Virtual Human Project is a powerful tool comprised of 3D computer-generated imagery videos designed to facilitate content comprehension. Leprosy (Hansen’s disease) is endemic in tropical countries, and has irreversible consequences. Effectively addressing this illness in medical schools is a crucial step towards its control, and the use of virtual educational tools can motivate learners to focus on this topic. The present study brings together the excellence of the TBL method and the power of the use of multimedia 3D materials to enhance learning.

Journal of Tropical Medicine and Health, 2018

Introduction: Leishmaniasis is parasitic disease caused by different species of Leishmania spp an... more Introduction: Leishmaniasis is parasitic disease caused by different species of Leishmania spp and transmitted by bites of phlebotomine sandflies. Tegumentary leishmaniasis affects the skin and may evolve with lesions on mucous membranes. The lesions are often seen in areas of the skin that are most exposed to insect bites, such as the legs, but there are cases described in various places in the body. In endemic areas, its diagnosis can be facilitated when skin lesions are ulcerations features with raised edges (framed) and the medical professional has experience in recognizing the disease. However, rare variants of the disease may hinder its diagnosis, such as Leishmaniasis Recidiva Cutis (LRC). This clinical form should be suspected in view of the appearance of new lesions in regions of previous scars of tegumentary leishmaniasis, or active lesions with poor response to conventional treatment. The gold standard diagnosis is the detection of the parasite in the tissue, however this research may be negative in these cases, and more detailed examinations may be necessary. LRC is often resistant to conventional therapies. Objective: To describe a case of LRC in which it was necessary to associate the intravenous treatment, intralesional injections and surgical removal of the remaining lesion. Methods: This article is a case report written from medical records of the patient. Main finding: This case required three different treatments to achieve remission, including N-methylglucamine antimoniate intravenous and intralesional, besides a surgery to remove the last parasitic focus. None all cases of LRC require this approach, but some patients are very resistant to conventional treatment. Conclusion: LRC is a rare disease and its treatment can be challenging, since sometimes it is necessary to associate different types of treatments.

Revista da Sociedade Brasileira de Medicina Tropical, 2014

Introduction: The primary strategy for tuberculosis control involves identifying individuals with... more Introduction: The primary strategy for tuberculosis control involves identifying individuals with latent tuberculosis. This study aimed to estimate the prevalence of latent tuberculosis in chronic kidney disease (CKD) patients who were undergoing hemodialysis in Campo Grande, State of Mato Grosso do Sul, Brazil, to characterize the sociodemographic and clinical profi les of patients with latent tuberculosis, to verify the association between sociodemographic and clinical characteristics and the occurrence of latent tuberculosis, and to monitor patient adherence to latent tuberculosis treatment. Methods: This epidemiological study involved 418 CKD patients who were undergoing hemodialysis and who underwent a tuberculin skin test. Results: The prevalence of latent tuberculosis was 10.3%. The mean patient age was 53.43±14.97 years, and the patients were predominantly men (63.9%). The population was primarily Caucasian (58.6%); half (50%) were married, and 49.8% had incomplete primary educations. Previous contact with tuberculosis patients was reported by 80% of the participants. Treatment adherence was 97.7%. Conclusions: We conclude that the prevalence of latent tuberculosis in our study population was low. Previous contact with patients with active tuberculosis increased the occurrence of latent infection. Although treatment adherence was high in this study, it is crucial to monitor tuberculosis treatment administered to patients in health services to maintain this high rate.

Anais Brasileiros de Dermatologia, 2018

Leiomyosarcoma is a rare skin tumor, most common in white men in the fifth to eighth decades of l... more Leiomyosarcoma is a rare skin tumor, most common in white men in the fifth to eighth decades of life. Primary tumors are classified in dermal or subcutaneous, that differ by clinical and prognostic features. They may appear on any site of the body, but are rare on the face. A 54-year-old female was admitted with a 5cm exophytic nodular lesion of 8 months duration on the right cheek, site of previous chronic radiodermatitis. Histopathology revealed spindle-shaped cell neoplasia, positive for smooth muscle actin on immunohistochemistry. Cutaneous leiomyosarcomas on the face are rare and may occur in previously irradiated areas. Immunohistochemistry is mandatory for an accurate diagnosis. Its similarity with other tumors may complicate the diagnosis, with delay expansion of the tumor.

Fogo Selvagem (FS) is mediated by pathogenic, predominantly IgG4, anti-Dsg1 autoantibodies and is... more Fogo Selvagem (FS) is mediated by pathogenic, predominantly IgG4, anti-Dsg1 autoantibodies and is endemic in Limao Verde (LV), Brazil. IgG and IgG-subclass autoantibodies were tested in a sample of 214 FS patients and 261 healthy controls by Dsg1-ELISA. For model selection, the sample was randomly divided into training (50%), validation (25%) and test (25%) sets. Using the training and validation sets, IgG4 was chosen as the best predictor of FS, with index values above 6.43 classified as FS. Using the test set, IgG4 has sensitivity 92% (95% CI: 82−95%), specificity 97% (95% CI: 89−100%) and area under the curve 0.97 (95% CI: 0.94−1.00). The IgG4 positive predictive value (PPV) in LV (3% FS prevalence) was 49%. The sensitivity, specificity and PPV of IgG anti-Dsg1 were 87%, 91% and 23%, respectively. The IgG4-based classifier was validated by testing 11 FS patients before and after clinical disease and 60 Japanese pemphigus patients. It classified 21/96 normal individuals from a LV ...

O vitiligo e uma doenca cutânea adquirida idiopatica caracterizada por despigmentacao devido a um... more O vitiligo e uma doenca cutânea adquirida idiopatica caracterizada por despigmentacao devido a uma destruicao cronica e progressiva dos melanocitos. E um achado dermatologico relativamente comum observado em 2% da populacao mundial. Apresenta-se um caso vitiligo associado a Sindrome Poliglandular Autoimune (SPA), destacando a importância da investigacao pelo dermatologista da SPA em pacientes com vitiligo. Paciente do sexo masculino, 32 anos, com diagnostico de vitiligo vulgar ha 17 anos, com historia de hipertireoidismo e anti-tireoperoxidase positivo ha 16 anos. Ha 1ano e 5 meses com diagnostico de anemia perniciosa. Ao exame fisico apresenta maculas acromicas bem delimitadas em axilas, cotovelos, maos, joelhos e pes. Considerando as patologias apresentadas pelo paciente, sugere-se o diagnostico de Sindrome Poliglandular Autoimune tipo 3. Discussao: Tendo em vista as publicacoes existentes sobre o tema, sugere-se a investigacao de doencas autoimunes em pacientes portadores de viti...

Anais Brasileiros de Dermatologia, 2019

Bullous dermAtoses Consensus on the treatment of autoimmune bullous dermatoses: pemphigus vulgari... more Bullous dermAtoses Consensus on the treatment of autoimmune bullous dermatoses: pemphigus vulgaris and pemphigus foliaceus-Brazilian Society of Dermatology*

BACKGROUND: American cutaneous leishmaniasis is a disease with a wide variety of clinical manifes... more BACKGROUND: American cutaneous leishmaniasis is a disease with a wide variety of clinical manifestations that is expanding throughout Brazil, the state of Mato Grosso do Sul constituting a significant endemic area. OBJECTIVES: To evaluate the clinical, epidemiological and laboratory characteristics of patients with American cutaneous leishmaniasis. Patients were recruited among those attending the Maria Aparecida Pedrossian Teaching Hospital of the Federal University of Mato Grosso do Sul, Brazil. METHODS: This was a cross-sectional, observational study conducted using a descriptive and analytical approach. Data from patients suspected of having American cutaneous leishmaniasis who were receiving care at this institute between 1998 and 2008 and were referred to the institute's parasitology laboratory for confirmation of diagnosis were evaluated retrospectively. Clinical and laboratory criteria were taken into consideration for the inclusion of patients to the study. RESULTS: Forty-seven patients were included in the study, the majority of whom were male and between 45 and 59 years of age. Most had the cutaneous form of the disease with a single, ulcerated lesion on exposed areas of the body, which had generally been present for periods of less than six months. Mucosal involvement increased with age and was highest in patients who had sought medical care at a later stage. The Montenegro skin test showed the highest sensitivity. Finding the parasite was more difficult in older lesions. CONCLUSION: Suspicion of the disease at an early stage is of extreme importance for a precise diagnosis. A combination of parasitological and immunological tests renders laboratory diagnosis more reliable.

Surgical & Cosmetic Dermatology, 2018

Basal cell carcinoma (BCC), also known as basal cell epithelioma, is the most frequent epithelial... more Basal cell carcinoma (BCC), also known as basal cell epithelioma, is the most frequent epithelial neoplasm in the dermatological practice, being more common in men. The authors report the case of a 75-year-old female patient with a BCC in the concha, anti-helix and triangular fossa regions of the right ear. The lesion was completely excised, including the cartilage. The surgical defect was repaired by means of a "saloon door" flap, which yields good aesthetic and functional outcomes. The posterior auricular flap is a versatile option for partial reconstruction of defects in the ear.

International Journal for Innovation Education and Research, 2020

Basal cell carcinoma is the most common malignant neoplasm in humans, with low mortality, high mo... more Basal cell carcinoma is the most common malignant neoplasm in humans, with low mortality, high morbidity, and exposure to solar radiation (UVB and UVA) is the most critical risk factor. Ultraviolet B rays generate mutagenic photoproducts in DNA and mutations in important genes regulating cellular functions, such as the tumor suppressor gene TP53. Ultraviolet A rays generate cytotoxic and mutagenic free radicals, potentiating the effects of UVB rays.. There is current evidence to support the role of inflammatory biomarkers related to tumorigenesis of basal cell carcinoma.

Anais brasileiros de dermatologia, 2017

Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune subepidermal blistering disease,... more Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune subepidermal blistering disease, with few cases described in childhood. It has different clinical-pathological features. We report a case of BSLE in a 10-year-old child with systemic lupus erythematosus, treated with prednisone and hydroxychloroquine. There was complete remission with dapsone, with no recurrence of skin lesions throughout one year of follow-up. We highlight the rarity and early age of occurrence.

Anais Brasileiros de Dermatologia, 2016

The Henoch-Schönlein purpura is the vasculitis associated with deposits of immunoglobulin A in sm... more The Henoch-Schönlein purpura is the vasculitis associated with deposits of immunoglobulin A in small vessels. Its association with cytoplasmic antineutrophil cytoplasmic antibodies is possible, but rare. This vasculitis is uncommon in adults and the main clinic manifestations are purpuric lesions in lower limbs with gastrointestinal symptoms and renal involvement. The present work describes a rare case of Henoch-Schönlein purpura in an adult with cytoplasmic antineutrophil cytoplasmic antibodies.

The American Journal of Tropical Medicine and Hygiene, 2010

Pemphigus foliaceus is a life threatening skin disease that is associated with autoimmunity to de... more Pemphigus foliaceus is a life threatening skin disease that is associated with autoimmunity to desmoglein, a skin protein involved in the adhesion of keratinocytes. This disease is endemic in certain areas of South America, suggesting the mediation of environmental factors triggering autoimmunity. Among the possible environmental factors, exposure to bites of black flies, in particular Simulium nigrimanum has been suggested. In this work, we describe the sialotranscriptome of adult female S. nigrimanum flies. It reveals the complexity of the salivary potion of this insect, comprised by over 70 distinct genes within over 30 protein families, including several novel families, even when compared with the previously described sialotranscriptome of the autogenous black fly, S. vittatum. The uncovering of this sialotranscriptome provides a platform for testing pemphigus patient sera against recombinant salivary proteins from S. nigrimanum and for the discovery of novel pharmacologically active compounds.