Enfermedad de Jorge Lobo o Blastomicosis queloidiana. Nuevos aspectos de la entidad en Colombia. Revisión

Abstract

Lobo's disease is a subcutaneous mycosis which was first described by Jorge Lobo in 1931 in a patient fron the Brazilian Amazon region. The first colombian case was reported in Cali (Universidad del Valle) in 1958. Lobo's disease in humans is unique to Latin-America. Over 260 cases of this disease have been reported, 135 from Brazil, 2 1 % of which have occurred among the Cayabi indian tribe. Until 1982, only nine colombian cases had been reported. Two of these were published twice, signifying that the acutal number of cases are seven. These were either mestizo or negro patients who attended teaching on local hospitals. In this paper we report ten cases of Lobomycosis is Amer Indians patients (Curripaco, Cubeo, Cuiba and Guahibo tribes), from Guainía, Vichada, Casanare and Vaupés regions. Their disgnosis was confirmed by skin biopsies sent to the National Institute of Health in Bogotá by physicians serving a compulsory year of social service. There are no previous reportes of this disease among colombian Amer-Indian communities. We also reviewed eigth patients either referred to us by colleagues or presented at the XIV National Congress of Dermatology, in 1984. Thus, the current number of reported cases of Lobomycosis in Colombia has risen to 2.5, making it the third highest frequency in the world behind Brazil and Surinam. The geographical regions where this disease is prevalent in Colombia are the Orinoco and Amazon rivers basins, where Amer-Indians patients are affected, and the Pacific Coast, where the black patients come from. Lobomycotic lesions are plaques and nodules of chronic evolution, which occur predominantely in male patients. Lobomycosis, most common complication is ulceration, making leishmaniasis the most important differential diagnosis. One Amer-Indian patient developed a squamous cell carcinoma over a Lobomycotic lesion with two-years of evolution. This patient was completely cured after surgical excision of the lesion. A general review of Lobomycosis is made and macro and microscopic features are illustrated.