Jorge Lobo's disease with restricted labial presentation

Miranda, Mario Fernando Ribeiro de; Unger, Deborah Aben-Athar; Brito, Arival Cardoso de; Carneiro, Fernando Augusto Ribeiro

doi:10.1590/S0365-05962011000200028

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

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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 ¹that primarily affects farm laborers between the ages of 21 and 40 years.²To 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

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