Overview
Lacaziosis is a cutaneous mycosis caused by the fungus Lacazia loboi, predominantly reported in Latin America, particularly the Amazon region. The immune response often exhibits a Th2 pattern, characterized by ineffective clearance of the fungus 1.Diagnosis
Direct Mycological Examination: Essential for identifying fungal elements 1.
Histological Analysis: Utilizes Gridley's staining to enhance visualization of fungal cells in skin biopsies 1.
Immunohistochemical Evaluation: Assesses B cells, plasma cells, and local expression of IgG and IgM antibodies to understand the humoral immune response 1.Management
No Specific Antifungal Therapy Mentioned: Current evidence does not specify first-line or adjunctive antifungal treatments 1.
Supportive Care: Focus on wound management and symptomatic relief 1.Special Populations
Limited Data: Abstracts do not provide specific guidance on management in pregnancy, pediatrics, elderly, or patients with comorbidities 1.Key Recommendations
Utilize direct mycological examination and histological analysis with Gridley's staining for definitive diagnosis of lacaziosis (Evidence: Moderate 1).
Consider immunohistochemical evaluation to assess the humoral immune response in affected lesions for deeper understanding (Evidence: Weak 1).
Implement supportive care measures including wound management due to lack of specific antifungal treatment recommendations (Evidence: Expert opinion 1).References
1 Kanashiro-Galo L, Alexandre AF, Tafuri WL, Barboza TC, Quaresma JAS, Brito AC et al.. Lacaziosis: immunohistochemical evaluation of elements of the humoral response in cutaneous lesions. Revista do Instituto de Medicina Tropical de Sao Paulo 2020. link