Lobomycosis
Other names:Lobo disease,[1]Jorge Lobo's disease,[2]Lacaziosis,[3]keloidal blastomycosis[4]
Lobomycosis
Specialty	Infectious diseases
Symptoms	Nodules,keloid[1]
Causes	Lacazia loboi[4]
Diagnostic method	Skin biopsy
Treatment	Surgical excision,cryosurgery[5]

Lobomycosis is afungal infection of theskin.^[4] It usually presents withbumps in the skin,firm swellings,deep skin lesions, or malignant tumors.^[1]

It is caused byLacazia loboi (formerly namedLoboa loboi).^[4] Transmission is generally by direct contact with contaminated water, soil, vegetation, or by direct contact with an infected dolphin.^[1]

Diagnosis is by identifyingLacazia laboi in a lesion.^[1]

This disease has been reported in humans andbottlenose dolphins, with the possible risk of transmission from one species to the other.^[6]

The condition was first described in 1931 byBrazilian dermatologistJorge Lobo.^[6]

Signs and symptoms

Infection most commonly develops after minor scratches orinsect bites, but many people cannot recall anyskin trauma. Human-to-human transmission does not occur, and the disease is only acquired from the environment.^[7] The disease manifests aschronickeloidal nodular lesions on theface,ears, or extremities.^{[citation needed]}

• 

  Nodular plaques covered by smooth and shiny skin

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  Multiple ill-defined, smooth, shiny, elastic nodules

Diagnosis

Diagnosis of Lobo's disease is made by taking a sample of the infected skin (skin biopsy) and examining it under themicroscope.^[4]Lacazia loboi is characterized by "lemon-shaped" fungi, a "sieve-like" appearance due to unstained fungi, and long chains ofspherical cells interconnected by tubules.^[4]

The cells appear to beyeast-like with a diameter of 5 to 12 μm. Attempts to cultureL. loboi have so far been unsuccessful.^{[citation needed]}

Differential diagnosis

The disease is often misdiagnosed asBlastomyces dermatitidis orParacoccidiodes brasiliensis due to its similar morphology.^{[citation needed]}

Treatment

Surgical excision orcryosurgery is the treatment of choice.^[5] Treatment withantifungals has been considered ineffective, but the use ofclofazimine anddapsone in patients withleprosy and lobomycosis has been found to improve the latter. This treatment regimen, with concomitantitraconazole, has been used to prevent recurrence after surgery.^[8]

Epidemiology

The disease isendemic in rural regions inSouth America andCentral America.^[7]

Other animals

Lesions in dolphins occur on the dorsal fin, head,flukes, andpeduncle. In January 2006, a potential epidemic of lobomycosis was reported in dolphins of theIndian River Lagoon inFlorida.^[9]

• 

  Lobomycosis lesions on the skin of a bottlenosed dolphin

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  Infected dorsal fin of wild bottle-nosed dolphin, Gulfo Dulce, Costa Rica

History

The condition was first described in 1931 byBrazilian dermatologistJorge Lobo.^[6] 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 theAmazon and meanthat which burns.

See also

• List of types of fungal infection

References

External links

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• Tropical diseases
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