ABSTRACT
Abstract We report a 74-year-old male presented to an outpatient dermatology clinic in Manaus, Amazonas, with a one-year history of pruritic, keloidal lesions on his left lower extremity. Histopathology showed round structures in reticular dermis. Grocott methenamine silver stain revealed numerous round yeasts with thick double walls, occurring singly or in chains connected by tubular projections. The diagnosis was lobomycosis. Although the keloidal lesions presented by this patient are typical of lobomycosis, their linear distribution along the left lower limb is unusual.
Subject(s)
Humans , Male , Aged , Lobomycosis/diagnosis , Lobomycosis/pathology , Keloid/diagnosis , Keloid/pathology , Leg Dermatoses/diagnosis , Leg Dermatoses/pathology , Biopsy , Dermis/microbiology , Dermis/pathologyABSTRACT
Abstract: Lobomycosis or lacaziosis is a chronic granulomatous fungal infection caused by Lacazia loboi. Most cases are restricted to tropical regions. Transmission is believed to occur through traumatic inoculation in the skin, mainly in exposed areas. It is characterized by keloid-like nodules. There are only a few hundred cases reported. The differential diagnoses include many skin conditions, and treatment is difficult. The reported case, initially diagnosed as keloid, proved to be refractory to surgical treatment alone. It was subsequently approached with extensive surgery, cryotherapy every three months and a combination of itraconazole and clofazimine for two years. No signs of clinical and histopathological activity were detected during follow-up.
Subject(s)
Humans , Male , Adult , Ear Diseases/pathology , Ear Diseases/therapy , Lobomycosis/pathology , Lobomycosis/therapy , Keloid/pathology , Biopsy , Treatment Outcome , Clofazimine/therapeutic use , Itraconazole/therapeutic use , Cryotherapy/methods , Diagnosis, Differential , Ear Diseases/diagnosis , Lobomycosis/diagnosis , Keloid/diagnosis , Antifungal Agents/therapeutic useABSTRACT
A Doença de Jorge Lobo é uma micose subcutânea que tem como agente etiológico o fungo Paracoccidioides loboi. Este fungo pode infectar tanto humanos quanto golfinhos. O primeiro caso em humanos foi registrado no Brasil em 1931. A história natural da doença se inicia pela instalação do microorganismo nos tecidos subcutâneos e as lesões são nodulares, isoladas, com aspecto queloideano, acometendo principalmente o pavilhão auricular e os membros inferiores e superiores. Geograficamente, esta micose ocorre mais em regiões de florestas densas, quentes e úmidas. O presente artigo teve por objetivo mostrar as características da doença em homens e em golfinhos.
Jorge Lobo's disease is a subcutaneous mycosis caused by the Paracoccidioides loboi, which can infect both humans and dolphins. The first case in humans was described in Brazil, in 1931. The disease´s natural history initiates after the infection by the microorganism. The lesions are solitary nodular keloid-looking that arises, mainly, in the ear and in the upper and lower limbs. Geographically, this mycosis shows itself in dense, hot and humid forest regions. This article aimed the presentation of the disease in humans and dolphins.