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which&#44; on dermatological examination&#44; revealed an extensive vegetating&#44; ulcerated plaque&#44; with bleeding due to minor traumas &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Excision of the lesion and histopathological examination showed a well-differentiated&#44; keratinizing&#44; and ulcerated squamous cell carcinoma &#40;SCC&#41;&#44; adjacent to the acute and chronic inflammatory process with giant cells and abundant fungal yeast structures compatible with <span class="elsevierStyleItalic">Lacazia loboi</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Left inguinal lymphadenectomy was also performed and the histopathological examination was compatible with metastatic SCC in one of the 13 examined lymph nodes&#44; with capsular extravasation&#46; Blood count was normal and serologies for hepatitis B and C and HIV viruses were negative&#59; computed tomography of the chest and abdomen showed no alterations&#46; He is currently being monitored at the oncology unit of a referral hospital&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">JLD&#44; first described in 1931 by Jorge Lobo in a patient from the Amazon region&#44; is a typical infection in tropical and subtropical areas&#44; more common in men aged 20 to 40 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> People who work in endemic areas and in contact with dense vegetation&#44; high humidity&#44; and high-temperature forests are susceptible to the disease&#46; Clinically&#44; it presents with polymorphic skin lesions&#44; single or multiple&#44; keloid-like nodules or plaques&#44; which are the most frequent clinical forms&#46; The lesions can progress with ulceration and secondary infection&#46; There is a possibility of lymphatic and hematogenous spread&#44; leading to multiple lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Old scars and chronic ulcers of any kind can lead to the development of SCC&#46; The degeneration into SCC in JLD has been described in a few cases in the world literature and can occur after a long period of disease evolution&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;5</span></a> One study showed two affected Brazilian natives from the Caiabi tribe who developed metastases and died&#44; even after surgical resection&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In the state of Par&#225;&#44; there have been reports in the literature of three patients with this transformation&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The therapeutic approach to JLD remains challenging to this day&#46; 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contributions</span><p id="par0020" class="elsevierStylePara elsevierViewall">Arival Cardoso de Brito&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Maraya de Jesus Semblano Bittencourt&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; critical review of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Thain&#225; da Silva Gon&#231;alves&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; 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Tropical/Infectoparasitary Dermatology
Jorge Lobo’s disease with malignant degeneration to squamous cell carcinoma: case report
Arival Cardoso de Britoa, Maraya de Jesus Semblano Bittencourtb,
Autor para correspondência
maraya@ufpa.br

Corresponding author.
, Thainá da Silva Gonçalvesb, Renata Henriques Cavalcanteb
a Service of Dermatology, Department of Dermatopathology, Universidade Federal do Pará, Belém, PA, Brazil
b Service of Dermatology, Universidade Federal do Pará, Belém, PA, Brazil
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which&#44; on dermatological examination&#44; revealed an extensive vegetating&#44; ulcerated plaque&#44; with bleeding due to minor traumas &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Excision of the lesion and histopathological examination showed a well-differentiated&#44; keratinizing&#44; and ulcerated squamous cell carcinoma &#40;SCC&#41;&#44; adjacent to the acute and chronic inflammatory process with giant cells and abundant fungal yeast structures compatible with <span class="elsevierStyleItalic">Lacazia loboi</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Left inguinal lymphadenectomy was also performed and the histopathological examination was compatible with metastatic SCC in one of the 13 examined lymph nodes&#44; with capsular extravasation&#46; Blood count was normal and serologies for hepatitis B and C and HIV viruses were negative&#59; computed tomography of the chest and abdomen showed no alterations&#46; He is currently being monitored at the oncology unit of a referral hospital&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">JLD&#44; first described in 1931 by Jorge Lobo in a patient from the Amazon region&#44; is a typical infection in tropical and subtropical areas&#44; more common in men aged 20 to 40 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> People who work in endemic areas and in contact with dense vegetation&#44; high humidity&#44; and high-temperature forests are susceptible to the disease&#46; Clinically&#44; it presents with polymorphic skin lesions&#44; single or multiple&#44; keloid-like nodules or plaques&#44; which are the most frequent clinical forms&#46; The lesions can progress with ulceration and secondary infection&#46; There is a possibility of lymphatic and hematogenous spread&#44; leading to multiple lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Old scars and chronic ulcers of any kind can lead to the development of SCC&#46; The degeneration into SCC in JLD has been described in a few cases in the world literature and can occur after a long period of disease evolution&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;5</span></a> One study showed two affected Brazilian natives from the Caiabi tribe who developed metastases and died&#44; even after surgical resection&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In the state of Par&#225;&#44; there have been reports in the literature of three patients with this transformation&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The therapeutic approach to JLD remains challenging to this day&#46; The therapy of choice depends on the clinical manifestation&#44; ranging from systemic antifungals&#44; electrocoagulation&#44; cryotherapy to surgical excision with wide margins&#46; Recurrence is frequent with any method&#46; The use of triazoles such as posaconazole seems to be promising&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;6</span></a> Overall&#44; the prognosis is good&#44; but with aesthetic and&#47;or functional impairment&#46; The emergence of SCC in chronic lesions of scars and ulcers of different etiologies has been reported by many authors in patients with chronic granulomatous diseases&#44; among which JLD should be included&#44; and these patients should be submitted to closer surveillance of ulcerated and chronic lesions&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financial support</span><p id="par0015" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Authors&#8217; contributions</span><p id="par0020" class="elsevierStylePara elsevierViewall">Arival Cardoso de Brito&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Maraya de Jesus Semblano Bittencourt&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; critical review of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Thain&#225; da Silva Gon&#231;alves&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Renata Henriques Cavalcante&#58; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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ISSN: 03650596
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