Abstracts
Jorge Lobo's Disease (JLD) is a chronic granulomatous cutaneous mycosis caused by Lacazia loboi. The most typical lesions are keloid-like growths preferentially located on limbs and ears. To the best of the authors' knowledge, only one labial case has previously been reported. We describe the case of a man who presented with a left-sided papulonodular lesion of 10 years' duration on the vermillion border of the upper lip. A successful surgical resection of the lesion was performed and there was no recurrence in eight years of follow-up.
Blastomycosis; Granulomatous disease, chronic; Pathology; Skin
Doença de Jorge Lobo (DJL) é infecção granulomatosa cutânea crônica produzida pelo fungo Lacazia loboi, cujas lesões mais típicas têm aspecto queloidiano, com localizações preferenciais em membros e orelhas. As lesões restringem-se à pele, havendo apenas uma referência, do conhecimento dos autores, à localização em semimucosa labial. Apresenta-se caso de doença de Jorge Lobo em paciente masculino, com lesão papulonodular no vermelhão do lábio superior, à esquerda, de dez anos de evolução, exitosamente submetida a tratamento cirúrgico, sem recidiva após oito anos.
Blastomicose; Doença granulomatosa crônica; Patologia; Pele
IMAGES IN TROPICAL DERMATOLOGY
IDermatology Specialist, SBD; Dermatopathology Specialist, UEMS/ICDP - Associate Professor of Dermatology at UFPA; Head of the Dermatopathology Laboratory in the Dermatopathology Service, ICS-UFPA, Belém, PA, Brazil
IIMSc in Tropical Diseases, UFPA; Dermatology Specialist, SBD - Associate Professor of Dermatopathology at UFPA, Belém, PA, Brazil
IIIPhD and Livre-Docência (Habilitation) in Dermatology, UFPA; Dermatology Specialist, UFPA - Professor on the Graduate Program in Tropical Diseases (Institute of Tropical Medicine, UFPA); Professor on the Graduate Program in the Biology of Infectious Agents, Institute of Biological Sciences, UFPA, Belém, PA, Brazil
IVDermatology Specialist, SBD - Dermatologist in a Private Practice, Belém, PA, Brazil
Mailing address
ABSTRACT
Jorge Lobo's Disease (JLD) is a chronic granulomatous cutaneous mycosis caused by Lacazia loboi. The most typical lesions are keloid-like growths preferentially located on limbs and ears. To the best of the authors' knowledge, only one labial case has previously been reported. We describe the case of a man who presented with a left-sided papulonodular lesion of 10 years' duration on the vermillion border of the upper lip. A successful surgical resection of the lesion was performed and there was no recurrence in eight years of follow-up.
Keywords: Blastomycosis; Granulomatous disease, chronic; Pathology; Skin
A 55-year-old, retired, male, dark-skinned farmer (Acará, PA) who had lived in Belém (PA) for 36 years presented in 1998 with a mildly pruriginous lesion on the upper lip of 10 years' duration. The lesion, which was located on the left of the upper lip, was dome-shaped and papulonodular, measured 1.0 cm and had a central depression and firm consistency. Jorge Lobo's disease (JLD) was confirmed by direct and histopathological examination. General clinical tests and additional tests requested (complete blood count; ESR; blood glucose level; glycosylated hemoglobin; serum levels of immunoglobulins and complement; anti-HIV antibodies; cell immunology; and urinalysis) did not show any alterations worthy of note. A wedge excision of the lesion was performed. Surgical margins were clear and there was no recurrence of the lesion in eight years.
JLD is a chronic granulomatous infection produced by the yeast-like fungus Lacazia loboi 1 that primarily affects farm laborers between the ages of 21 and 40 years.2 To the authors' knowledge, there is only one case of a patient with a lesion on the lip among the 490 cases recorded worldwide up to 20063.4
REFERENCES
- 1. Taborda PR, Taborda VA, McGinnis MR. Lacazia loboi gen. nov., comb. nov., the etiologic agent of lobomycosis. J Clin Microbiol. 199;37:2031-33.
- 2. Baruzzi RG, Lacaz CS, Souza FAA. História natural da doença de Jorge Lobo. Ocorrência entre índios Caiabi (Brasil Central). Rev Inst Med Trop São Paulo. 1979;21:302-30.
- 3. Brito AC, Quaresma JAS. Lacaziose (doença de Jorge Lobo): revisão e atualização. An Bras Dermatol. 2007;82:461-74.
- 4. Loureiro AAP, Brito AC, Silva D. Micose de Jorge Lobo de localização insólita. An Bras Dermatol. 1971;46:1-6.
Jorge Lobo's disease with restricted labial presentation
Publication Dates
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Publication in this collection
16 May 2011 -
Date of issue
Apr 2011
History
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Received
22 Feb 2010