It is caused by Lacazia loboi (formerly named Loboa loboi).[5] Transmission is generally by direct contact with contaminated water, soil, vegetation, or by direct contact with an infected dolphin.[1]
Diagnosis is by identifying Lacazia laboi in a lesion.[1]
This disease is usually found in humans[6] and
bottlenose dolphins, with the possible risk of transmission from one species to the other.[7]
It was discovered by
Brazilian dermatologist
Jorge Lobo. Other names which were given to the disease are: keloidal blastomycosis, Amazonian blastomycosis, blastomycoid granuloma, miraip and piraip. These last two names were given by natives of the
Amazon and mean that which burns.[8]
Signs and symptoms
The disease is
endemic in rural regions in
South America and
Central America. Infection most commonly develops after minor scratches or
insect bites, but many patients cannot recall any
skin trauma. Human-to-human transmission does not occur, and the disease is only acquired from the environment.[9] The disease manifests as
chronickeloidal nodular lesions on the ears, legs, or arms.[10]
Diagnosis of Lobo's disease is made by taking a sample of the infected skin (a
skin biopsy) and examining it under the
microscope. Lacazia loboi is characterized by long chains of spherical cells interconnected by tubules. The cells appear to be
yeast-like with a diameter of 5 to 12 μm. Attempts to culture L. loboi have so far been unsuccessful.[10]
Surgical excision or
cryosurgery is the treatment of choice.[11] Treatment with
antifungals has been considered ineffective, but the use of
clofazimine and
dapsone in patients with
leprosy and lobomycosis has been found to improve the latter. This treatment regimen, with concomitant
itraconazole, has been used to prevent recurrence after surgery.[12]
Other animals
Lesions in dolphins occur on the dorsal fin, head,
flukes, and
peduncle. In January 2006, a potential epidemic of lobomycosis was reported in dolphins of the
Indian River Lagoon in
Florida.[13]
^Baruzzi RG, Lacaz CS, Souza FA (1979). "História natural da doença de Jorge Lobo. Ocorrência entre os índios Caibi (Brasil Central)". Rev Inst Med Trop Sao Paulo. 21: 302–338.
Carvalho, K. A. D., Floriano, M. C., Enokihara, M. M. S., & Mascarenhas, M. R. M. (2015). Jorge Lobo’s disease. Anais brasileiros de dermatologia, 90(4), 586–588.
Paniz-Mondolfi, A., C. Talhari, L.S. Hoffmann, D.L. Connor and S. Talhari & al. (2012) Lobomycosis: An emerging disease in humans and delphinidae. Mycoses, 55: 298-309 |
résumé.