Navegando por Assunto "Lobomicose"

Agora exibindo 1 - 6 de 6

Acesso aberto (Open Access)
Doença de Jorge Lobo: estudo histopatológico retrospectivo de casos registrados no serviço de dermatologia da Universidade Federal do Pará no período de 1967 a 2009
(Universidade Federal do Pará, 2010) BITTENCOURT, Maraya de Jesus Semblano; BRITO, Arival Cardoso de; http://lattes.cnpq.br/0563291980190339
Jorge Lobo‟s disease (JLD) or lacaziosis is a chronic, granulomatous skin and subcutaneous tissue infection caused by the fungus Lacazia loboi. Clinical lesions are generally polymorphous, often presenting with a keloid-like aspect, and most often involving ears or limbs. Histopathology remains the “gold standard” exam to reach diagnosis. Few clinical-pathological correlation studies on this disease are available to date. Our goal was to systematically review cases of JLD diagnosed at the dermatopathology laboratory of the Dermatology Service of the Federal University of Pará, Brazil, from 1967 to 2009. After a thorough chart review, we could retrieve demographic and clinical data, as well as histopathological features from each case studied. 59 biopsies from 45 patients were evaluated. The sample consisted of 37 men and eight women, with a mean age of 50 years. Most patients were agricultural workers (55%), of which 93% were males. Fifty-nine percent of the lesions showed a keloid-like appearance. Verrucous (8%), plaque (3%), gummatous (1%), and hyperchromatic macular (1%) lesions were less frequently observed. Most skin lesions occurred on the lower limbs (56%). Histopathologically, the stratum corneum showed hyperkeratosis in 71% of the biopsies, associated with parakeratosis in 37% and with orthokeratosis in 50%. Transepidermal elimination of parasites (TEP) was present in 36% of the cases in association with hyperkeratosis in 95% (p=0.0121) and with parakeratosis in 90% (p<0.0001). The epidermis showed a hyperplastic appearance in 58% of the specimens, was atrophic in 29%, normal in 12%, and ulcerated in 8% of them. There was a hyperplastic epidermis (86%, p=0.0054) in sites where TEP took place. We could also observe the presence of parasites in the epidermis in 30% of the biopsies, in which an association with TEP occurred in 89% (p<0.0001). There was no statistically significant relationship between the occurrence of TEP and the clinical aspect of the lesion (p=0.4231). Lymphocytes, macrophages and giant cells of the foreign-body type were predominant in the infiltrate, being observed in 100% of the cases. Plasma cells were seen in 35%, neutrophils in 15%, and eosinophils in 11% of the cases. There was a statistically significant relationship between the occurrence of TEP and the presence of neutrophil infiltration (p=0.0016). An exudative reaction pattern was present in 10% of the biopsies, and 11% exhibited focal areas of necrosis. Langhans giant cells were observed in 59% of the biopsies, and asteroid bodies in 5%. Pseudo-Gaucher cells were present in 69% of the cases, and fibrosis in 96%. The infiltrate showed extension to the reticular dermis in all cases, and to the deep dermis in 88%. A subcutaneous spread of the infiltrate occurred in 10% of the cases, with identification of parasites within the fat tissue in one of them. As for age distribution, sex and profession of the patients, the data overlapped those of the literature. The results allowed us to evaluate epidemiological, clinical and histopathological profiles of the disease, which in certain respects differed from the classically described ones of the literature, especially concerning characteristics of the epidermis, inflammatory cell infiltrate, and location of lesions.
Acesso aberto (Open Access)
Imunoexpressão para CD1a em lesões cutâneas na doença de Jorge Lobo
(Universidade Federal do Pará, 2009) UNGER, Deborah Aben-Athar; BRITO, Arival Cardoso de; http://lattes.cnpq.br/0563291980190339
Jorge Lobo’s disease (DJL) is a chronic infection caused by the fungus Lacazia loboi, endemic in South America, especially in the Brazilian Amazon region. The most common clinical presentation is parakeloidal lesion located mainly in the lower limbs in men who practice agricultural activity. The fungus can be identified by both mycological and anatomopathological examination. The main objective of this study was to investigate the possible role of Langerhans' cells (LC) in the pathogenesis of the disease in tissue samples from skin lesions, using immunohistochemical technique. Thirty-three medical records were selected with their respective paraffin blocks of skin biopsies from patients with DJL (group 1) registered in the dermatology service at the Federal University of Para in the period from 1955 to 2005. The control group consisted of 10 paraffin blocks from normal skin (group 2) and 42 blocks from patients with paracoccidioidomycosis (PCM) (Group 3). In the analysis of patient medical records data were collected regarding age, sex, origin, profession, location and clinical type of the lesions. Langerhans cells were identified by immunohistochemistry using anti-CD1a antibody (Serotec). Patients were mostly men (84, 8%), farmers (72. 7%) aged between 46-65 years, with predominance of parakeloidal lesions (81. 8%) in the lower limbs (45. 5%). The number of positive cells was statistically analyzed. The LC were visualized along the epidermis in all biopsies from Jorge Lobo's disease. The morphology and the number of cells, did not differ from normal skin (p> 0. 05), and was increased when compared to the PCM lesions (p <0. 05). Langerhans cells were present in Jorge Lobo’s disease skin lesions similarly to the way they are in normal skin, not suffering any numerical or morphological alterations, unlike what occurred in PCM. These results suggest that in DJL fungi probably present some escape mechanism of the local immune system to evade the antigen presentation by Langerhans’ cells.
Acesso aberto (Open Access)
Imunomarcação tecidual para o fator XIIIa+ em dendrócitos dérmicos de lesões cutâneas com doença de Jorge Lobo
(Universidade Federal do Pará, 2010) CARNEIRO, Clivia Maria Moraes de Oliveira; BRITO, Arival Cardoso de; http://lattes.cnpq.br/0563291980190339
Jorge Lobo's disease (DJL) is a deep fungal infection caused by Lacazia loboi which mainly affects males farmers, with the clinical form keloid and location of the lower limbs. The highest incidence is found in the Brazilian Amazonia. There are few reports on immune tissue lesions of patients. This study aims to evaluate a possible role in the pathogenesis of the disease by factor XIIIa dermal dendrocytes (FXIIIa DD) in skin lesions, using the technique of immunohistochemistry. 33 skin biopsies were analyzed from patients with DJL. The control group consisted of 10 normal skin biopsies originating from patients without dermatological diseases and 61 biopsies from patients with paracoccidioidomycosis (PCM). The results obtained by records analyzing patients' revealed that DJL affects mainly men (84.8%), farmers (72.7%) with 46-65 years old (51.5%), coming from the northeastern Pará state (51.5%) with clinical form keloid (81.8%) and predominant location of lesions in the lower limbs (45.5). The values of the count of FXIIIa DD in skin lesions of DJL were not affected by variations in gender, age, occupation, origin, clinical manifestation and localization of lesions. The amount of FXIIIa DD in patients with DJL was higher than that found in the control group of patients with healthy skin and in the group of patients with PCM to both the histopathology of loose granuloma (GF) and organized granuloma (GBO). Because of FXIIIa DD be considered precursors of Langerhans cells (LCs) can be suggested that their increase in DJL reflects a reservoir for the LCs and transform them time and again, don’t allowing their decrease. It has been demonstrated the increase in the levels of Th2 cytokines (TGF-β) in the DJL, and the increase of FXIIIa DD that is able to secrete the factor TNF-α, observed in this study, shows a dominance of Th1. Whereas there is a co expression of cytokine profiles of both, the study suggests the existence of mixed patterns. So, the results obtained in this work suggest that DJL is a spectral disease, with a tendency of resistance or susceptibility. What might explain the existence of focal cases even with long duration of disease and disseminated cases like early manifestation of DJL.
Acesso aberto (Open Access)
Imunopatogenia da interação entre acrófagos e/ou células de Langerhans e Lacazia loboi
(Universidade Federal do Pará, 2014-04-24) YAMANO, Suellen Sirleide Pereira; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125
Lobomycosis is a chronic, granulomatous, fungal infection of the skin and subcutaneous caused by the fungus Lacazia loboi. This mycosis occurs predominantly in Amazon region and affect all populations groups. Histologically, there is a chronic inflammatory reaction characterized by the intense fibroplastia and histiocytosis, abundant number of macrophages, multinucleated giant cells and presence of large numbers of yeast. Macrophages are phagocytic cells that participate in the recognition and response to pathogens through phagocytosis, antigen presentation to T lymphocytes and cytokine production. Langerhans cells (LC) are a group of dendritic cells (DC) derived from bone marrow, which are located mainly in the suprabasal layer of the epidermis. Studies on hostfungal interaction in Jorge Lobo's disease are scarce. Therefore, this study constitutes an important step towards a better understanding of L. loboi biology and pathogenesis, enabling in vitro culture of this organism endemic in Amazon region and study of their antigenic properties, as well as new therapeutic approaches. The objective of this study was to analyze the in vitro interaction between non-activated peritoneal macrophages and/or Langerhans cells isolated from BALB/c mice and L. loboi, calculating infection, phagocytosis and cellular fusion rates; also measuring the production of TNF, IL-4, IL-6, IL-10 and IL-12. Results showed that L. loboi is phagocytosed by macrophages but not by LC. Phagocytosis and infection rates in the interaction between macrophages and L. loboi was similar to interaction between macrophages, Langerhans cells and L. loboi at all times analyzed. The mean number of yeast cell per macrophage was almost equal among interactions and over time, with mean variation from 1.2 to 1.6 yeast/macrophages. No giant cells formation in coculture studied. No significant difference occurred in IL-4, Il-2 and IL-10 production between interactions studied. TNF levels decrease in interaction between macrophages and L. loboi while adding LC induces increased production of TNF-α, especially after 48 hours. LC negatively modulate IL-6 production by macrophage and L. loboi also inhibits this production by macrophages alone or cocultured with LC. L. loboi stimulated significantly IL-12 production by macrophages co-cultured with LC, but not for LC alone or macrophages.
Acesso aberto (Open Access)
Isolamento e cultivo in vitro do agente etiológico da Doença de Jorge Lobo: morfologia, fisiologia e genoma de Candida loboi sp. nov
(Universidade Federal do Pará, 2015-12-18) COSTA, Patricia Fagundes da; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125
Jorge Lobo’s disease is a chronic granulomatous infection developing after traumatic implantation of the fungus in the skin. It presents with nodular, verrucous or keloid-like lesions mainly on legs and ears. The highest prevalence is at Amazon Region and it has been considered an emergent disease, presenting new cases on other continents in both, humans and dolphins. Little is known about L. loboi, and the absence of in vitro culture impairs the correct characterization of the fungus. This work had as the main goal to isolate, culture and characterize strains of the etiological agent of Jorge Lobo´s disease, obtained from patients attended at the Dr Marcello Candia Reference Unit in Sanitary Dermatology of the State of Pará, in Marituba, Pará, Brazil. During many years 23 patients were diagnosed and followed by our team. Most of them were male farmers, with age varying from 14 to 80 years-old. After biopsy of the lesion for confirming the diagnosis, the patients initiated treatment and the material was processed with dispase II at liquid medium RPMI, 37º C, 5% CO2 for 1-2 weeks to isolate yeast cells from human tissue. After 2-6 months in the medium, we observed fragmentation of mother cells and the presence of new yeast cells with diameter varying from 1 to 7μm. From that moment, it was possible to grow the strains in different liquid or solid mediums at 37º C or RT, where creamy, whitish cerebriform, sometimes hairy colonies were observed. Cells from those strains were analyzed by different techniques of optical and electron microscopy, biochemistry and genetics, ending with the description of the genome of one patient just after isolation of the fungal cells from the lesional skin, defining the following taxonomic identification: Eukaryota; Fungi; Dikarya; Ascomycota; Saccharomycotina; Saccharomycetes; Saccharomycetales; Debaryomycetaceae; Candida/Lodderomyces clade; Candida; Candida sp. LDI48194. The peculiar clinical presentation associated to unique morphological, physiological and genetic characteristics that do not permit the definition of a known species indicate that the etiological agent of Jorge Lobo’s disease is a new species, for which we propose to use the name Candida loboi.
Acesso aberto (Open Access)
Lacaziose (doença de Jorge Lobo): revisão e atualização
(2007-10) BRITO, Arival Cardoso de; QUARESMA, Juarez Antônio Simões
Lacaziosis, also known as Jorge Lobo s disease, lobomycosis and keloidal blastomycosis, is a chronic cutaneous and subcutaneous fungal granulomatous disease, caused by Lacazia loboi – an uncultivated fungal pathogen – characterized by the development of nodular keloidal lesions, particularly on the pinnae, face, upper and lower limbs, and with no involvement of mucous membranes. Most cases in humans were reported in South America, including the Caiabi Indians, in Central Brazil. The disease was described in non-human mammals, such as two species of dolphins (Tursiops truncatus and Sotalia guianensis) inhabiting the coasts of Florida (USA), South America (Suriname River estuary, Santa Catarina-Brazil coast) and Gulf of Gascony (Biscaya Bay, in Europe). The histopathological findings in dolphins were very similar to those observed in humans. The aspects related to the history, etiology, epidemiology and ecology, clinical manifestations, differential diagnosis, immunohistochemistry, pathology, ultrastructural, laboratory diagnosis and therapy of lacaziosis, are presented.