L C Cucé

University of São Paulo, San Paulo, São Paulo, Brazil

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Publications (28)33.73 Total impact

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    ABSTRACT: The first case of cutaneous cryptococcosis in a renal transplant patient successfully treated with fluconazole is reported. A 59-year-old renal transplant female patient receiving immunosuppressive therapy developed cutaneous cellulitis on the posterior aspect of the right thigh, which ulcerated. Diagnosis of cutaneous cryptococcosis was confirmed by culture and histopathological and mycological examination. There was no sign of involvement of other organs. Fluconazole 300 mg/day orally was started; after 93 days the dose was increased to 400 mg/day. Clinical, mycological and histopathological cure was obtained after 182 days of treatment. In spite of immunosuppressive therapy, fluconazole was successful in treating the disease, and there was no relapse over the following year. Treatment had no adverse influence on renal function.
    No preview · Article · Jul 2009 · Journal of Dermatological Treatment
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    ABSTRACT: This paper reports a case of disseminate sporotrichosis with cutaneous, mucous, osseous, and ocular lesions, a fact rarely registered in the literature, mainly because it happened in Brazil where this mycosis is frequent. The cutaneous and mucous lesions were severe, causing irreversible sequelae. Of special gravity was the ocular lesion resulting in blindness of the affected eye. The study showed no altered delayed immunity. The possibility of an aereal inoculation of the agent is discussed. The experiments with test animals do not demonstrate special virulence of the strain isolated from the patient. The response to the iodine treatment was unsatisfactory, as was the response to ketoconazole. The response to amphotericin B was considered satisfactory. Zusammenfassung: Die Arbeit bezieht sich auf einen Fall von Sporotrichosis disseminata mit Haut-, Schleimhaut-, Knochen- und Augenläsionen. Ein Vorfall selten in der Literatur registriert, bemerkenswert, da er in einem Land, Brasilien, vorkam, wo Mykose eine alltägliche Erscheinung ist. Die Haut- und Schleimhautläsionen waren heftig mit unabänderlichen Folgeerscheinungen. Von besonderer Schwere war die Augenläsion, die zur Erblindung des befallenen Auges führte. Der Befund verzögerter Immunität war normal. Diskutiert wurde die Möglichkeit einer Einimpfung des Erregers. Die Teste mit Versuchstieren zeigen keine spezielle Virulenz des vom Patienten isolierten Erregers. Die Reaktion auf Jodbehandlung war nicht zufriedenstellend, wie auch die Reaktion auf Ketoconazole nicht den Erwartungen entsprach. Die Behandlung mit Amphotericin konnte als zufriedenstellend angesehen werden.
    No preview · Article · Apr 2009 · Mycoses
  • Z.N.P. Oliveira · R C Leão · L C Cucé
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    ABSTRACT: We have evaluated clinical and laboratorial effects of immunostimulation scarification with antigen of Paracoccidioides brasiliensis in patients with paracoccidioidomycosis, who often show depressed immunity. We have studied 62 Brazilian patients with paracoccidioidomycosis, 46 with active disease and 16 cured, in a 10-year period between 1982 and 1992. Among the 46 patients with active disease: 10 had acute form, 12 chronic unifocal form and 24 the chronic multifocal form of the disease; 16 showed positive paracoccidioidin intradermal reaction and 30 negative reaction. Amongst 16 cured patients, 5 showed negative paracoccidioidin intradermal reaction and 11 positive reaction. We immunostimulated 20 patients by scarification with polysaccharide antigen of Paracoccidioides brasiliensis. All 20 immunostimulated patients had negative paracoccidioidin intradermal reaction, and 18 patients had active disease and 2 were cured. Out of 18 immunostimulated patients with active disease, 3 had active form, 10 chronic multifocal form and 5 chronic unifocal form of the disease. Before and after immunostimulation, each patients was inmunologically evaluated by in vivo and in vitro methods; in vivo methods consisted of intradermal reactions and DNCB sensitization tests; and in vitro methods consisted of total sub-set lymphocyte counting, leukocytes migration inhibition test, chemotaxix of total leukocytes and monuclear leukocyte phagocytosis. Remaining 42 patients served as a non-immunostimulated control group who has followed only clinically. We have observed significant clinical and immunological improvement in immunostimulated patients. We conclude that the immunostimulation by scarification with antigen of P. brasiliensis can be a helpful adjuvant therapy for paracoccidioidomycosis.
    No preview · Article · Jan 1996 · Allergologia et Immunopathologia
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    ABSTRACT: Influence of Montenegro skin test for American tegumentar leishmaniasis was evaluated to verify possible interference in serological diagnosis for this disease, performed by immunoenzymatic assay (ELISA). If this interference could occur, it would hamper scientific, epidemiological and patient care; happily we did not find any interference on serological diagnosis by performance of skin testing.
    No preview · Article · Jan 1996 · Revista do Hospital das Clínicas
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    ABSTRACT: We report three cases of subcutaneous phaeohyphomycosis due to Exophiala jeanselmei (Langeron) McGinnis et Padhye 1977, in kidney transplant patients. Exophiala jeanselmei is a dematious fungus having also ability to rarely procedure eumycetoma (black grains). According to KWON-CHUNG & BENNETT (1992) such fungus is antigenically very heterogeneous, since so far three serotypes have been identified; each serotype including subgroups. Subcutaneous phaeohyphomycosis is becoming more and more frequent in kidney transplant patients submitted to an immunosuppressive treatment. As Exophiala jeanselmei has already been isolated from the environment it becomes difficult to explain the pathogenicity of these cases by a reactivation of quiescent processes. The authors suggest an occasional fungistatic action of cyclosporine A upon Exophiala jeanselmei.
    No preview · Article · Mar 1994 · Revista do Instituto de Medicina Tropical de São Paulo
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    ABSTRACT: Mycetoma is a rare deep mycosis caused by certain fungi. Clinical findings include enlargement and tumefaction of the affected region accompanied by grains coming out of the lesions. The feet are the most frequently affected area. Four patients have been studied who presented with mycetoma of the feet. Gallium scintigraphy was always abnormal in the affected areas and bone scintigraphy was abnormal in three of the four patients. The patient who had a normal bone study had received effective treatment (7 years). In the other patients the results were poor. Scintigraphic findings seem to be similar to those noted in cases of acute osteomyelitis associated with cellulitis, despite long-term therapy. Bone and gallium studies may be of possible value for therapy follow-up in cases of mycetoma.
    No preview · Article · Oct 1993 · Nuclear Medicine Communications
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    ABSTRACT: We report three cases of sporotrichosis successfully treated with oral fluconazole. A verrucous lesion on the toe was cured after 126 days, and a lesion on the left foot resolved after 91 days' treatment. A case of lymphangitic-type sporotrichosis required 174 days of treatment to achieve a cure, and a higher dose (400 mg daily) was necessary in this case. Any side-effects were insignificant. We conclude that this new bis-triazole compound can be successfully used as an alternative treatment for sporotrichosis when conventional drugs must be avoided.
    No preview · Article · Apr 1993 · British Journal of Dermatology
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    ABSTRACT: Clinical and epidemiological aspects of 41 cases of mycetoma seen in São Paulo city from January 1978 to December 1989 are presented. Twenty-eight cases (68%) were caused by actinomycetes, while 13 (32%) were caused by true fungi. In only 22 (78%) actinomycetoma cases was it possible to identify the agent. Nocardia brasiliensis, by far the commonest actinomycete isolated, was responsible for 13 cases. Among eumycetomata, Madurella grisea was isolated from 3 cases, Scedosporium apiospermum from 2 cases, and Madurella mycetomatis from 1 case, and in 7 cases the agent was not identified. Distribution by sex and age was similar to that reported in the literature. Feet and legs were the commonest sites affected. The mean age of actinomycetoma patients was 33.2 years, while patients with eumycetoma were an average of 32.8 years. Mean duration of the disease was 6.8 and 9.8 years respectively. Most patients came from rural areas in the north-eastern region of the country and worked as field labourers. Bone involvement was frequent for both actinomycetomata and eumycetomata and was characterized by osteoporosis, periostal reaction and cavitation. The authors' elected treatment consists of combining sulfamethoxazole (800 mg) and trimethoprim (100 mg) with prednisone (10 mg) orally, daily. Zusammenfassung. Es werden die klinischen und epidemiologischen Aspekte von 41 Myzetompatienten vorgestellt, die in São Paulo in der Zeit von Januar 1978 bis Dezember 1989 beobachtet wurden. Achtundzwanzig Fälle wurden durch Aktinomyzeten verursacht (68%), 13 durch Eumyzeten (32%). Nur bei 22 Aktinomyzetomen (78%) war es moglich, den Erreger zu identifizieren. Nocardia brasiliensis stellte mit 13 Fällen den größten Anteil. Bei den Eumyzetomen wurde Madurella grisea dreimal, Scedosporium apiospermum zweimal und Madurella mycetomatis einmal isoliert, in sieben Fällen konnte der Erreger nicht identifiziert werden. Die Geschlechts- und Altersverteilung entsprach den Literaturangaben. Die unteren Extremitäten waren die am häufigsten befallenen Bereiche. Das Durchschnittsalter der Aktinomyzetom-Patienten lag bei 33.2 Jahren, das der EumyzetomPatienten bei 32.8 Jahren. Die mittlere Dauer der Krankheit lag bei 6.8 Bzw. 9.8 Jahren. Die meisten Patienten kamen von ländlichen Gegenden der Nordostregion des Landes, bei der Mehrzahl handelte es sich um Landarbeiter. Knochenbeteiligung war häufig und war charakterisiert durch Osteoporose, periostale Reaktionen und Kavitätenbildung. Die Autoren behandelten mit Sulfamethoxazol (800 mg) und Trimethoprim (100 mg) kombiniert mit Prednison (10 mg) täglich oral.
    No preview · Article · Mar 1993 · Mycoses
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    ABSTRACT: Os Autores registram dois casos de eumicetoma de grãos pretos, com localização podal, procedentes da Bahia, provocados por Madurella grisea Mackinnon et al., 1949. São estudadas a estrutura dos grãos, bem como as características micromorfológicas do fungo em vida saprofítica. Acreditam os Autores que estas observações correspondem ao sétimo e oitavo casos registrados na literatura do país, provocadas por este fungo. Os Autores consideram nomen dubium ou nomina confusa as seguintes espécies de Madurella: M. ramiroi, M. oswaldoi, M. bovoi, M. tozeuri, M. mansonii, M. brumpti, M. reynieri, M. americana, M. lackawanna e M. ikedae, o mesmo ocorrendo com a chamada Rubromadurella mycetomi. As únicas espécies válidas são Madurella mycetomatis McGinnis, 1980 (=Madurella mycetomi Brumpt, 1905) e Madurella grisea Mackinnon et al., 1949. Nos dois casos registrados o tratamento com itraconazol, por um período de 3 meses não fez regredir as lesões, havendo ligeira melhora clínica.
    Preview · Article · Dec 1992 · Revista do Instituto de Medicina Tropical de São Paulo
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    ABSTRACT: Two cases of black grains eumycotic mycetoma, occurring on a foot, are reported. Both proceeded from the state of Bahia (Brazil), and in both the etiologic agent was Madurella grisea Mackinnon et al., 1949. The grains structure as well as the micromorphologic characteristics of the fungus in saprophytic life were studied. It is the author's belief that these observations correspond to the 7th and 8th cases reported in the Brazilian medical literature. The authors do consider the following Madurella species as nomen dubium or nomina confusa: M. ramiroi, M. oswaldoi, M. bovoi, M. tozeuri, M. mansonii, M. brumpti, M. reynieri, M. americana, M. lackawanna e M. ikedae and the same for Rubromadurella mycetomi. The only valid species must be Madurella mycetomatis McGinnis, 1980 (= Madurella mycetomi Brumpt, 1905) and Madurella grisea Mackinnon et al., 1949. Treatment with itraconazole in both reported cases, for a 3 month duration, did not produce any regression of the lesions, the clinical improvement being meager.
    No preview · Article · Nov 1992 · Revista do Instituto de Medicina Tropical de São Paulo
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    ABSTRACT: Paracoccidioidomycosis was studied in 62 patients from Brazil in the 10 year period between 1978 and 1988. In 46 patients included in a first group, the disease was active and in 16 patients included in a second group, the disease was cured. The study was conducted according to both the clinical form of the disease and the response to paracoccidioidin in both groups. In the first group, 10 patients presented the acute form, 12 presented the chronic unifocal form and 24 had the chronic multifocal form of the disease. As to the response to paracoccidioidin, in the first group 16 patients were negative and 30 were positive; in the second group, 11 were positive and 5 were negative. An immunological study was performed in all patients using in vivo methods such as skin tests and sensitization to DNCB and in vitro techniques such as total lymphocyte counts, T and B cell counts, leukocyte migration inhibition test, chemotaxis of total leukocytes and mononuclear leukocyte phagocytosis.
    No preview · Article · Jul 1992 · Allergologia et Immunopathologia
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    ABSTRACT: Plasma samples of 14 patients with paracoccidioidomycosis were analysed for components that represent activation of the complement system. Most patients (12/13) showed significant titres of complement-fixing antibodies and 14/14 had increased C4d/C4 ratios. There was no conclusive correlation between these two immunological indices, however. Factor B values of patients were similar to normal donors and fragment Ba was not detected in any of the patients. These results indicate a classical complement pathway activation in the plasma of patients with paracoccidioidomycosis.
    No preview · Article · Feb 1992 · Journal of medical and veterinary mycology: bi-monthly publication of the International Society for Human and Animal Mycology
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    ABSTRACT: A case of rhinofacial entomophthoromycosis caused by Conidiobolus coronatus is reported in a 30-years-old male from São Paulo, Brazil. The patient was successfully treated with oral fluconazole in a prolonged regimen. The diagnosis was confirmed by histopathological and mycological data.
    No preview · Article · Jan 1992 · Revista do Instituto de Medicina Tropical de São Paulo
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    ABSTRACT: A case of rhinofacial zygomycosis with of years duration, caused by Conidiobolus coronatus is described. The patient, a 72-years-old woman, presented with a bilateral distortion of the subcutaneous tissue and disfigurement of the face. Treatment with ketoconazole and potassium iodide did not prevent several relapses. At present she is still under treatment with fluconazole with clinical healing. Histopathological and mycological examination confirmed the dermatological diagnosis. An increasing number of cases of zygomycosis caused by fungi of the order Entomophthorales have also been reported in the Northern and Northeastern States of Brazil.
    No preview · Article · Aug 1991 · Mycopathologia
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    ABSTRACT: A case of rhinofacial zygomycosis with of years duration, caused by Conidiobolus coronatus is described. The patient, a 72-years-old woman, presented with a bilateral distortion of the subcutaneous tissue and disfigurement of the face. Treatment with ketoconazole and potasium iodide did not prevent several relapses. At present she is still under treatment with fluconazole with clinical healing. Histopathological and mycological examination confirmed the dermatological diagnosis. An increasing number of cases of zygomycosis caused by fungi of the order Entomophthorales have also been reported in the Northern and Northeastern States of Brazil.
    No preview · Article · Jun 1991 · Mycopathologia
  • V.M.S. Dos Reis · L C Cucé · E A Rivitti
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    ABSTRACT: A group of 16 patients with endemic pemphigus foliaceus under corticotherapy and still showing erythematous, papulous, verrucous, in general hyperpigmented lesions, which were characterized as cortico therapy resistant lesions, were studied. Such study was made through anatomopathology and direct immunofluorescence (DIF). Anatomopathologically, such lesions showed tendencies to epithelial hyperplasia and cleavage in variable levels at the epidermis what differs from the early lesions of EPF and coincides with the chronic injuries of the EPF of the pre-corticoid era. The DIF of the injured skin was positive for IgG in 93.75% of cases, as it happens in the early stages of EPF, being negative in a simple case in which there was not cleavage. In addition, in eight of those patients, the DIF of the healthy skin and the indirect immunofluorescence (IIF) were studied. The DIF was positive in three of these cases and in all eight the IIF was negative.
    No preview · Article · Jan 1991 · Revista do Instituto de Medicina Tropical de São Paulo
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    Luis Carlos Cucé · Walter Belda Júnior · Mabel Cristina Dias

    Preview · Article · Aug 1990 · Revista do Instituto de Medicina Tropical de São Paulo
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    ABSTRACT: The authors present the results obtained in the treatment of pityriasis versicolor with Itraconazole, comparing two schemes of treatment, in an open trial: 200 mg daily, for 5 and 7 days. The clinical diagnosis was confirmed by Wood's light and mycologically, by direct examination. The patients were controlled 21 and 35 days after beginning the treatment. The evaluation of the results showed that both schemes were effective. At the second control, there was clinical and mycologic cure in 90% of the patients from the 5-day group and in 95% of the patients from the 7-day group. The tolerance was good: 2 patients from the 7-day group and 1 patient from the 5-day group showed side-effects. Since there was no significant difference between the two schemes of treatment, the authors recommend the shortest one, that is, 200 mg daily for 5 days.
    No preview · Article · May 1990 · Revista do Instituto de Medicina Tropical de São Paulo
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    Preview · Article · Feb 1990 · Revista do Instituto de Medicina Tropical de São Paulo
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    ABSTRACT: Four cases of Tinea favosa occurred in the same family are reported in a small city of Brazil (Itapecerica da Serra--State of São Paulo). Trichophyton schoenleinii was isolated from all four cases. Treatment consisted of oral griseofulvin (10 mg/kg/day) for at least three months.
    No preview · Article · Jan 1990 · Revista do Instituto de Medicina Tropical de São Paulo

Publication Stats

169 Citations
33.73 Total Impact Points

Institutions

  • 1986-2009
    • University of São Paulo
      • • Hospital das Clínicas (FMUSP)
      • • Departamento de Dermatologia (FM) (São Paulo)
      San Paulo, São Paulo, Brazil
  • 1992
    • Federal University of Pernambuco
      Arrecife, Pernambuco, Brazil
    • Oklahoma City University
      Oklahoma City, Oklahoma, United States
  • 1991
    • Hospital do Servidor Público Estadual "Francisco Morato de Oliveira"
      San Paulo, São Paulo, Brazil