Enfermedad de Jorge Lobo o Blastomicosis queloidiana. Nuevos aspectos de la entidad en Colombia. Revisión

Toro, Gerzaín Rodríguez

doi:10.7705/biomedica.v9i3-4.1985

Cited by 13 publications

(10 citation statements)

References 4 publications

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“…The similarities are based on the fact that all these diseases reveal and antigen‐specific immunodeficiency with a strong Th2 type response and a clear inability for eliminating the parasite forms, with the subsequent development of disseminated lesions and refraction to treatment, except for leprosy for which today there is adequate chemotherapy. It is important to consider that Lobomycosis may concur with other infectious illnesses, such as dermatophytoses, 10,62 chromoblastomycosis, 63 paracoccidiodomycosis 64 and leprosy 65…”

Section: Differential Diagnosismentioning

confidence: 99%

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Lobomycosis: an emerging disease in humans and delphinidae

Paniz-Mondolfi

Talhari

Hoffmann

et al. 2012

Mycoses

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Summary Lobomycosis, a disease caused by the uncultivable dimorphic onygenale fungi Lacazia loboi, remains to date as an enigmatic illness, both due to the impossibility of its aetiological agent to be cultured and grown in vitro, as well as because of its unresponsiveness to specific antifungal treatments. It was first described in the 1930s by Brazilian dermatologist Jorge Lobo and is known to cause cutaneous and subcutaneous localised and widespread infections in humans and dolphins. Soil and vegetation are believed to be the chief habitat of the fungus, however, increasing reports in marine mammals has shifted the attention to the aquatic environment. Infection in humans has also been associated with proximity to water, raising the hypothesis that L. loboi may be a hydrophilic microorganism that penetrates the skin by trauma. Although its occurrence was once thought to be restricted to New World tropical countries, its recent description in African patients has wrecked this belief. Antifungals noted to be effective in the empirical management of other cutaneous/subcutaneous mycoses have proven unsuccessful and unfortunately, no satisfactory therapeutic approach for this cutaneous infection currently exists.

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Section: Differential Diagnosismentioning

confidence: 99%

“…7) i.e. Brazil (endemic), 9,10 Colombia, 11,62 Suriname, 47 Venezuela, 4,48,56 French Guyana, 6,46,73–75 Guyana, 6,46 Ecuador 6,46 Costa Rica, 6,46,76 Panama, 6,46,77,78 Peru, 6,79,80 Bolivia 10,81 and Mexico 6 . There have also been cases imported in the United States, 82 Canada, 83 Europe (France) 6,84 and South Africa 14 …”

Section: Epidemiologymentioning

confidence: 99%

Lobomycosis: an emerging disease in humans and delphinidae

Paniz-Mondolfi

Talhari

Hoffmann

et al. 2012

Mycoses

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“…To date, occurences of Jorge Lobo’s disease in humans were reported in nine countries of South America (Brazil, Colombia, 26 , 64 , 65 Suriname, 66 Venezuela, 58 , 67 – 71 Guyana, French Guiana, 72 – 74 Ecuador, 75 Peru, 76 – 78 and Bolivia 79 ), three countries of Central America (Panama, 80 , 81 Costa Rica, 82 and Mexico), and imported cases in the United States, 83 Canada, 84 France, 85 Netherlands, 86 Germany, 87 Greece, 88 and South Africa. 69 …”

Section: Introductionmentioning

confidence: 99%

Lobomycosis: epidemiology, clinical presentation, and management options

Francesconi¹,

Klein²,

Santos³

et al. 2014

TCRM

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Lobomycosis is a subcutaneous mycosis of chronic evolution caused by the Lacazia loboi fungus. Its distribution is almost exclusive in the Americas, and it has a particularly high prevalence in the Amazon basin. Cases of lobomycosis have been reported only in dolphins and humans. Its prevalence is higher among men who are active in the forest, such as rubber tappers, bushmen, miners, and Indian men. It is recognized that the traumatic implantation of the fungus on the skin is the route by which humans acquire this infection. The lesions affect mainly exposed areas such as the auricles and upper and lower limbs and are typically presented as keloid-like lesions. Currently, surgical removal is the therapeutic procedure of choice in initial cases. Despite the existing data and studies to date, the active immune mechanisms in this infection and its involvement in the control or development of lacaziosis have not been fully clarified. In recent years, little progress has been made in the appraisal of the epidemiologic aspects of the disease. So far, we have neither a population-based study nor any evaluation directed to the forest workers.

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“…It has been found mostly in Brazil, in the Mato Grosso region and Amazonian valley, 3 where the Cayabi Indian tribe has a high prevalence of lobomycosis: 21% of all reported cases in the literature 4 , 5 . It has also been described in Surinam, French Guyana, Colombia, 6 Venezuela, Central America, and Mexico; there are isolated case reports from Ecuador, Peru, and Bolivia 7 . Approximately 307 cases have been described 8…”

mentioning

confidence: 99%

“…It has been found to affect regional lymph nodes in 10% to 25% of cases 12 . Squamous cell carcinoma has been described, notably in the Cayabi Indians on old scar lesions 5 , 6 . There is only one case described with testicular involvement, in a patient from Costa Rica 13 .…”

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confidence: 99%

Lobomycosis in three Venezuelan patients

Brun

1999

Int J Dermatology

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Case 1. A 52‐year‐old Brazilian man consulted us for a growth on his forehead (Fig. 1). He came from the Amazon region, had been a gold miner for many years, and had noticed a papule on his forehead that had grown slowly for 3 years. On inspection, a 3‐cm, smooth, shiny, elastic nodule was found, the same color as the skin. The clinical diagnosis was lobomycosis; a small sample was taken with a scalpel blade, placed in KOH 20%, and numerous round cells in small chains were seen. Biopsy confirmed the diagnosis. He was treated with surgical excision and was lost to follow‐up. 1 Case 1: growth on the forehead Case 2. An 83‐year‐old Venezuelan man was brought to us by his daughter for an ulcerated verrucous plaque, measuring 6 cm by 4 cm, on his right sole (Fig. 2). The lesion was firm, had started at the age of 63 years as a papule, and later became a plaque which had ulcerated recently. He had been a gold and diamond miner for most of his life, in the southeastern Venezuelan state of Bolívar. The clinical diagnosis was epithelioma cuniculatum. The histology showed pseudoepitheliomatous hyperplasia, numerous cells in giant cells, and histiocytes; Grocott stain showed chains of uniform round to oval cells (Fig. 3 and 4). Over the years, he was treated with ketoconazole and itraconazole to no avail; new nodules appeared on the dorsum of the foot and on his leg (Fig. 5). He is now 98 years old, and fit except for lobomycosis. He has no lymphadenopathy and no neoplastic degeneration of his lesions. 2 Case 2: ulcerated verrucous plaque on the sole 3 Case 2: histology (hematoxylin and eosin) 5 Case 2: nodules on the foot Case 3. A 64‐year‐old man from the gold mining region of El Callao, in Bolívar state, was hospitalized for severe heart failure; a mass of nodules was noticed on his right arm (Fig. 6) and we were asked for a consultation. He had worked for many years in the underground gold mines and the lesions had been present for more than 25 years. On inspection, a mass of smooth, shiny, firm, pedunculated, and sessile nodules was seen on the posterior lateral aspect of his right arm; some were hypopigmented, others hyperpigmented. The impression was of a bunch of plums, measuring 6 cm by 12 cm. The clinical diagnosis was plexiform neurofibromas vs angiofibromas. The biopsy showed atrophic epidermis, numerous round cells in giant cells, and no lymphocytic infiltrate; Grocott stain showed single budding with chain formation. The patient was treated with partial surgical excision, but was lost to follow‐up. 6 Case 3: mass of nodules on right arm Discussion

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Enfermedad de Jorge Lobo o Blastomicosis queloidiana. Nuevos aspectos de la entidad en Colombia. Revisión

Cited by 13 publications

References 4 publications

Lobomycosis: an emerging disease in humans and delphinidae

Lobomycosis: an emerging disease in humans and delphinidae

Lobomycosis: epidemiology, clinical presentation, and management options

Lobomycosis in three Venezuelan patients

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