Garcia M, Chanlin R, Blanchet D, Demar M, Couppie P, Blaizot R
Service de dermatologie, Hôpital Andrée Rosemon, Cayenne, Guyane.
Laboratoire hospitalo-universitaire de parasitologie-mycologie, Cayenne, Guyane.
Med Sante Trop. 2019 Nov 1;29(4):377-380. doi: 10.1684/mst.2019.0947.
Case report from French Guiana of an atypical keloid in a Brazilian man: Lobomycosis. Lobomycosis is a rare fungal skin infection, endemic to the Amazon basin. Its clinical manifestations are slow-growing keloid-like nodules, with a granulomatous reaction on histopathology. The etiological agent, Lacazia loboi, has never been isolated in the environment or cultured in a laboratory. Diagnosis is based on the typical appearance on microscopy. Treatment is disappointing, with a high recurrence rate. We report a new case in French Guiana and review the literature. Only 10 cases have been reported outside of the endemic area, 2 involving no travel; the mean time to diagnosis was 21 years. Phylogenetic analysis has recently proved that lobomycosis in dolphins is caused by a fungus more closely related to Paracoccidioides brasiliensis than to L. loboi (two very closely related species). Molecular diagnosis is possible in a few centers. Climate change may result in spreading lobomycosis to currently disease-free areas of the world.
罗博真菌病。罗博真菌病是一种罕见的真菌性皮肤感染，在亚马逊盆地流行。其临床表现为生长缓慢的瘢痕疙瘩样结节，组织病理学上有肉芽肿反应。病原体罗博拉克azia从未在环境中分离出来或在实验室培养过。诊断基于显微镜下的典型表现。治疗效果不佳，复发率高。我们报告法属圭亚那的一例新病例并回顾相关文献。在流行区以外仅报告了10例病例，其中2例与旅行无关；诊断的平均时间为21年。系统发育分析最近证明，海豚身上的罗博真菌病是由一种与巴西副球孢子菌关系比与罗博拉克azia更密切的真菌引起的（两种密切相关的物种）。少数中心可以进行分子诊断。气候变化可能导致罗博真菌病传播到世界上目前无病的地区。
