No abstract

Jorge Lobo's Disease is a rare, chronic granulomatous cutaneous mycosis, which is typical of tropical and subtropical regions. It is caused by the traumatic implantation of the fungus Lacazia loboi into the skin and subcutaneous tissue. The disease was first described in 1931 by Jorge Lobo, in Recife (PE), Brazil. It is common in Central and South America, and predominates in the Amazon region. We report a case of Jorge Lobo's Disease, which had been initially referred as being paracoccidioidomycosis. We emphasize clinical and diagnostic features of the disease.

The COVID-19 pandemic has had a huge impact on the health of millions of people around the world on an unprecedented scale. Unfortunately, the process of creating effective antiviral drugs and vaccines is being delayed. Therefore, drugs that are already available and may have an effect on COVID-19 are being investigated. Due to the fact that viral infection often affects the cardiovascular system, causing myocardial infarction, viral myocarditis, tachyarrhythmias and stress cardiomyopathies, a theory was put forward that HMG-CoA reductase (3-hydroxy-3methyl-glutaryl-CoA reductase) inhibitors (statins) can reduce the risk of cardiovascular complications in these patients. In recent years, this class of drugs has been proposed, including for viral infections, such as the influenza virus or MERS-CoV. The review discusses both the latest clinical data on the efficacy of statins in COVID-19 and the pleotropic mechanisms of statins that can limit the pathogenic effect of viruses. In particular, statins can act on lipid cell rafts (subdomains of the plasma membrane), decreasing their lipid concentration; limiting the interaction of the virus with the receptors of angiotensin-converting enzyme-2 and CD-147. Statins have an antiinflammatory effect (blocking the molecular mechanisms of inflammation, including NF-κB and NLRP3), limit the development of a “cytokine storm” in severe patients with COVID-19; can inhibit SARS-CoV-2 basic protease; influence coagulation, limit sympathetic activity and have other effects. In two large cohort observational studies (n = 96032 and n = 13981), hospitalized patients with COVID-19 who were taking statins showed a decrease in hospital mortality and mortality 28 days after the admission to the hospital. Thus, statins can play a role in the treatment of COVID-19.

Everolimus, a mammalian target of rapamycin inhibitor, is an emerging drug, which is being increasingly applied in oncology and solid organ transplantation. Oral ulcers are a frequent side effect associated with this immunosupressor. We report the case of a renal transplant recipient who developed disfiguring oral and perianal ulcers secondary to everolimus's toxicity. This is probably the first report of perianal involvement. Dermatologists need to be aware of the potential mucocutaneous adverse effects related to these new drugs that are becoming evermore common in our clinical practice.