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Grotta G, Couppie P, Demar M, Drak Alsibai K, Blaizot R. Fungal Density in Lobomycosis in French Guiana: A Proposal for a New Clinico-Histological and Therapeutic Classification. J Fungi (Basel) 2023; 9:1005. [PMID: 37888260 PMCID: PMC10608060 DOI: 10.3390/jof9101005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Lobomycosis is a rare cutaneous tropical neglected disease caused by the fungal agent Lacazia loboi, recently renamed Paracoccidioides lobogeorgii. Our objectives were to present all cases of lobomycosis diagnosed in French Guiana, to offer a precise description of their histopathological features and to propose a new clinico-histological prognostic classification. METHODS All cases of lobomycosis diagnosed in French Guiana between 1959 and 2022 were included. We looked for associations between the occurrence of relapses and the clinic-histological form. RESULTS 31 patients diagnosed with lobomycosis were included. An epidemiological shift was observed in the 2000s as Brazilian patients became the most important ethnic group. Gold mining, forestry and fishing/sailing were reported as professional exposures. New histological features, such as inflammatory "rosettes" formations were described. We describe two clinic-histological patterns: a major form (high fungal density and/or multifocal lesions) and a minor form (low fungal density, unifocal lesions, association with fewer relapses). CONCLUSIONS The changing epidemiology of lobomycosis in French Guiana is characterized by a shift towards Brazilian patients, mostly gold miners. Minor forms should be treated with surgery, major forms with a combination of surgery followed by nultiple drug therapy (MDT) or posaconazole.
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Affiliation(s)
- Geoffrey Grotta
- Dermatology Department, Cayenne Hospital, Cayenne 97306, French Guiana; (G.G.); (P.C.)
| | - Pierre Couppie
- Dermatology Department, Cayenne Hospital, Cayenne 97306, French Guiana; (G.G.); (P.C.)
- UMR TBIP Tropical Biomes and Immunophysiopathology, University of French Guiana, Cayenne 97300, French Guiana;
| | - Magalie Demar
- UMR TBIP Tropical Biomes and Immunophysiopathology, University of French Guiana, Cayenne 97300, French Guiana;
- Parasitology Department, Cayenne Hospital, Cayenne 97306, French Guiana
| | - Kinan Drak Alsibai
- Histopathology Department, Centre Hospitalier de Cayenne, Cayenne 97306, French Guiana;
| | - Romain Blaizot
- Dermatology Department, Cayenne Hospital, Cayenne 97306, French Guiana; (G.G.); (P.C.)
- UMR TBIP Tropical Biomes and Immunophysiopathology, University of French Guiana, Cayenne 97300, French Guiana;
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Valentin J, Niemetzky F, Gaillet M, Michaud C, Carbunar A, Demar M, Couppie P, Blaizot R. Spectrum of skin diseases in Maroon villages of the Maroni area, French Guiana. Int J Dermatol 2022; 61:1137-1144. [PMID: 35767188 PMCID: PMC9543587 DOI: 10.1111/ijd.16324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/08/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Due to their genetic characteristics and their high exposure to infectious diseases, Maroons are likely to suffer from a specific spectrum of skin diseases. However, skin disorders have never been explored in this population. We aimed to describe all skin diseases in Maroon villages of the Maroni region in French Guiana. METHODS This retrospective study concerned all patients who consulted in the remote health centers of Apatou, Grand-Santi, Papaichton, and Maripasoula between October 5, 2017, and June 30, 2020. We included all patients registered with a skin disorder (International Classification of Diseases) in the medical database. We excluded patients whose diagnosis was invalidated after cross-checking by a dermatologist. RESULTS A total of 4741 patients presented at least one skin disease, for 6058 different disorders. Nonsexually transmitted infections represented 71.6% of all diagnoses, followed by inflammatory diseases (9.8%) and bites/envenomations (4.6%). The three most frequent conditions were scabies, abscesses, and impetigo. Besides scabies, neglected tropical diseases (NTDs) were still prevalent as we reported 13 cases of leprosy and 63 cutaneous leishmaniasis. Atopic dermatitis (AD) represented only 2.5% of our diagnoses. CONCLUSIONS With the exception of AD, which was less frequent among Maroons, these results are similar to those previously reported in Amerindians. Therefore, a common exposure to rainforest pathogens seems to induce a common spectrum of skin diseases dominated by infections. The high prevalence of NTDs requires specific public health actions.
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Affiliation(s)
- Julie Valentin
- Dermatology Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Florence Niemetzky
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Melanie Gaillet
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Celine Michaud
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Aurel Carbunar
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Magalie Demar
- Tropical Biome and Immunophysiopathology (TBIP), Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Centre Hospitalier de Cayenne, Université de Guyane, Cayenne, French Guiana.,Laboratory of Parasitology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Pierre Couppie
- Dermatology Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana.,Tropical Biome and Immunophysiopathology (TBIP), Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Centre Hospitalier de Cayenne, Université de Guyane, Cayenne, French Guiana
| | - Romain Blaizot
- Dermatology Department, Centre Hospitalier de Cayenne, Cayenne, French Guiana.,Tropical Biome and Immunophysiopathology (TBIP), Université de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Centre Hospitalier de Cayenne, Université de Guyane, Cayenne, French Guiana
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Wagner G, Moertl D, Glechner A, Mayr V, Klerings I, Zachariah C, Van den Nest M, Gartlehner G, Willinger B. Paracoccidioidomycosis Diagnosed in Europe-A Systematic Literature Review. J Fungi (Basel) 2021; 7:157. [PMID: 33672212 PMCID: PMC7926554 DOI: 10.3390/jof7020157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
Paracoccidioidomycosis is a systemic mycosis that is endemic in geographical regions of Central and South America. Cases that occur in nonendemic regions of the world are imported through migration and travel. Due to the limited number of cases in Europe, most physicians are not familiar with paracoccidioidomycosis and its close clinical and histopathological resemblance to other infectious and noninfectious disease. To increase awareness of this insidious mycosis, we conducted a systematic review to summarize the evidence on cases diagnosed and reported in Europe. We searched PubMed and Embase to identify cases of paracoccidioidomycosis diagnosed in European countries. In addition, we used Scopus for citation tracking and manually screened bibliographies of relevant articles. We conducted dual abstract and full-text screening of references yielded by our searches. To identify publications published prior to 1985, we used the previously published review by Ajello et al. Overall, we identified 83 cases of paracoccidioidomycosis diagnosed in 11 European countries, published in 68 articles. Age of patients ranged from 24 to 77 years; the majority were male. Time from leaving the endemic region and first occurrence of symptoms considerably varied. Our review illustrates the challenges of considering systemic mycosis in the differential diagnosis of people returning or immigrating to Europe from endemic areas. Travel history is important for diagnostic-workup, though it might be difficult to obtain due to possible long latency period of the disease.
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Affiliation(s)
- Gernot Wagner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Deddo Moertl
- Clinical Department of Internal Medicine III, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, Dunant-Platz 1, 3100 St. Poelten, Austria;
| | - Anna Glechner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Verena Mayr
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Irma Klerings
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Casey Zachariah
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
| | - Miriam Van den Nest
- Department for Infection Control and Hospital Epidemiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
| | - Gerald Gartlehner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Strasse 30, 3500 Krems, Austria; (A.G.); (V.M.); (I.K.); (C.Z.); (G.G.)
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
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Malmontet T, Guarmit B, Gaillet M, Michaud C, Garceran N, Chanlin R, Demar M, Couppie P, Blaizot R. Spectrum of skin diseases in Amerindian villages of the Upper Oyapock, French Guiana. Int J Dermatol 2020; 59:599-605. [PMID: 32227343 PMCID: PMC7217172 DOI: 10.1111/ijd.14848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/25/2020] [Accepted: 02/21/2020] [Indexed: 12/15/2022]
Abstract
Background Due to their genetic characteristics, their isolation in rainforest areas, and their traditional way of life, Amerindian populations are likely to suffer from a specific spectrum of dermatoses. However, there are few available data on such skin disorders. Our aims were to describe all skin disorders in two Amerindian villages of French Guiana. Methods This retrospective study concerned all patients who consulted in the Health Centres of Camopi and Trois‐Sauts between July 1, 2017, and December 31, 2018. We included all patients classified with an ICD code linked to a skin disorder. All medical records were cross‐checked by two dermatologists to correct misclassifications. Results A total of 639 patients formed the study population, for 866 different skin disorders. Non‐sexually transmitted infections represented 57.6% of all skin disorders, followed by eczema (11.5%) and bites/envenomations (9.1%). Bacteria were responsible for 238 skin infections, followed by fungi (141 cases) and parasites (69 cases, including 43 scabies, nine cutaneous leishmaniasis, and two tungiasis). We reported a low prevalence of sexually transmitted infections (10 cases) and an absence of skin cancers. Conclusions This study revealed the absence of skin cancer in the Amerindian population of the Upper Oyapock and the important burden of infectious and animal‐related diseases. Future studies should assess a possible underestimation of sexually transmitted diseases in this area. Public health policies should target neglected diseases such as cutaneous leishmaniasis, tungiasis, scabies, and envenomations. Atopic dermatitis was a significant and unexpected cause of consultations.
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Affiliation(s)
- Thomas Malmontet
- Dermatology Department, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Basma Guarmit
- Health Centres for Remote Areas, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Melanie Gaillet
- Health Centres for Remote Areas, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Celine Michaud
- Health Centres for Remote Areas, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Nicolas Garceran
- Health Centres for Remote Areas, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Romain Chanlin
- Laboratory of Parasitology-Mycology, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Magalie Demar
- Laboratory of Parasitology-Mycology, Andrée Rosemon Hospital, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, University of French Guiana, Cayenne, French Guiana
| | - Pierre Couppie
- Dermatology Department, Andrée Rosemon Hospital, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, University of French Guiana, Cayenne, French Guiana
| | - Romain Blaizot
- Dermatology Department, Andrée Rosemon Hospital, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, University of French Guiana, Cayenne, French Guiana
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