Lobomycosis in Soldiers, Colombia

Abstract

Lobomycosis is a disease that is endemic to the Amazon rainforest and is caused by the still uncultured fungus Lacazia loboi. This disease occurs in loggers, farmers, miners, fishermen, and persons living near coastal rivers of this region. We report 6 soldiers in Colombia in whom lobomycosis developed after military service in the Amazon area. The patients had nodular and keloid-like lesions on the face, neck, trunk, and limbs. The duration of illness ranged from 2 years to 15 years. The initial diagnosis was leishmaniasis on the basis of clinical manifestations and direct smear results, but biopsies confirmed the final diagnosis of lobomycosis. Treatment with surgical excision, itraconazole and clofazimine was satisfactory. However, the follow-up time was short. Healthcare professionals responsible for the diagnosis and treatment of skin diseases need to be able to recognize the clinical signs of lobomycosis and differentiate them from those of cutaneous leishmaniasis.

Lobomycosis post long-term corticosteroid therapy: a case report

“…Lobomycosis or Lacaziosis or Jorge Lobo's disease or Keloidal Blastomycosis, or Amazonic Blastomycosis, is a chronic granulomatous infection of the cutis and subcutis caused by the fungal species L. loboi (formerly Loboa loboi and Paracoccidioides loboi) that can infect humans and dolphins (Arenas et al, 2019;Arju et al, 2014;de Sousa et al, 2015;Francesconi et al, 2014;Grayson & Colonje, 2020;Hall et al, 2017;Pasqualotto et al, 2021;Queiroz-Telles et al, 2017).…”

“…It is believed that the role of environmental factors (environmental exposure) plays a more critical role in the risk of this fungal infection, (Arju et al, 2014) including the tendency for men to be more infected with lobomycosis than women due to the greater risk of exposure to the environment in men (Arenas et al, 2019). In Florian's study, 2020, it was stated that Kaiabi tribal women in Brazil turned out to have a high enough prevalence to experience lobomycosis due to activities in close contact with the environment, and most cases had early disease onset since the age of <21 years with the youngest age one year due to premature contact on wood and soil (Florian et al, 2020).…”

Multidrug Therapy for Leprosy Can Cure Patients with Lobomycosis in Acre State, Brazil: A Proof of Therapy Study

“…Case reports have shown successful outcomes following surgical excision and antifungal and/or antitubercular drug use (e.g., itraconazole, posaconazole, and clofazimine). [9][10][11] However, the Acre Dermatology Service noted a high disease recurrence risk with this approach, especially in disseminated disease. 12,13 Furthermore, completion of therapy may be hampered by the high cost of antifungals.…”

Downregulation of Epac Reduces Fibrosis and Induces Apoptosis Through Akt Signaling in Human Keloid Fibroblasts

“…3 In addition, the active growth period of keloids is often accompanied with symptoms including itching and pain, which severely affect the quality of life of patients. 4 In this study, we used the novel Epac-specific inhibitor ESI-09, which inhibits Epac1/2, and found that it blocks Akt phosphorylation in human normal dermal fibroblasts (HDFs) and human keloid fibroblasts (HKFs). We found that inhibiting expression of Epac1 decreases extracellular matrix synthesis, cell proliferation, cell migration, and induces apoptosis in HDFs and HKFs by preventing Akt phosphorylation We, therefore, predict that Epac1 is a potential therapeutic target for preventing keloid formation.…”