Lobomycosis

#idboardreview 40 M from Amazon region of Columbia presents with slowly progressive disfiguring ear lesion and leg lesion. Diagnosis? #medEd #IDMedEd

#Lobomycosis chronic granulomatous infection of skin & subQ tissues caused by fungus L. loboi: slowly developing (months, yrs or decades) keloid-like, ulcerated or verrucous nodular or plaque-like lesions usually at site of local trauma cut, insect bite, animal bite or ray sting

Lesions single or multiple tend to occur on exposed, cooler areas of body ext & ears. dermal granulomas w/ multinucleated giant cells filled w/ lemon-shaped fungal cells 6–12 μm in diameter double refractile walls in chains of budding cells connected by thin, tube-like bridges

Lobomycosis 1st by dermatologist Jorge Lobo 1931. His patient was rubber collector in Amazonas state of Brazil w/ slow nodular keloidal lesions in spine area: similar to paracocci he called keloidal blasto. 2nd case 1938 & since>500 cases

Surgical tax w/ wide margins is treatment of choice. Some case reports of clofazimine, itra and posaconazole has been described

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323076/

Originally tweeted by Indiana University Infectious Diseases Fellowship (@IUIDfellowship) on 28 October, 2020.

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