Ten years experience with Jorge Lobo's disease in the state of Acre, Amazon region, Brazil

Abstract

SUMMARYJorge Lobo's disease is a cutaneous and subcutaneous mycosis that affects patients in the Amazon region. The number of patients is relatively small, but the real situation of the disease as public health problem is not known, because Jorge Lobo's disease is not a notifiable disease. This study aims to report the clinical evolution in patients affected and to determine the prevalence and areas of occurrence of the disease. A retrospective study was carried out based on the analysis of the clinical records, which included a collection of photographs of patients in the Department of Sanitary Dermatology, in Rio Branco, and patients seen in the interior of the state. In a decade, in Rio Branco, 249 cases of the disease were reported, 30 were females and 219 males. Of these patients, 153 had localized lesions, 94 of them were on one ear, 55 had multifocal lesions and 41 had disseminated lesions. The average time between the onset of symptoms and diagnosis was 19 years. The average age at the time of diagnosis was 53 years, and ages ranged from 14 to 96 years.

Lobomycosis Successfully Treated with Posaconazole

“…Amphotericin B, 5-fluorocytosine, ketoconazole, itraconazole, and clofazamine have been used with limited or no success. 1,6,7 Although a few patients have benefited from a combination of clofazimine and itraconazole therapy, no systematic evaluation supports this recommendation. 8 Favorable results after surgical excision or cryosurgery have been obtained in early and small well-circumscribed lesions, but relapses at the margin of the excision may still occur.…”

“…1,2 Peru has reported only two cases to date. 3,4 Lobomycosis is characterized by subcutaneous nodules with keloid-like, ulcerated, or verrucomatous surfaces.…”

Lobomycosis: an emerging disease in humans and delphinidae

“…Interestingly as per the experience of the Leprosy elimination Programme of Acre (Brazil), patients with lobomycosis and concurrent leprosy have shown to respond to multibacillary therapy with reduction of pruritus and size of the mycotic nodules. 120 This unanticipated response to the abovementioned therapy may be due to the synergistic anti-granulomatous effects of cloflazimine along with the well known antifungal actions of Rifampin, 121 opening a whole new perspective on the therapeutic approach to this clinical entity.…”

Lobomicose

“…20 A clofazimina, 100-300 mg por dia, apresentou uma diminuição do número de fungos, além de alguns casos de regressão das lesões. 22 Em caso de remoção cirúrgica, torna-se necessário o acompanhamento do paciente por longo período de tempo devido à recorrência da dermatose. Até ao momento presente, o tratamento farmacológico não mostrou resultados satisfatórios na remissão completa da doença.…”