Disseminated infection with Lacazia loboi and immunopathology of the lesional spectrum

SummaryThe pathogenesis of lacaziosis continues to be obscure, and works have investigated the blood systemic immune response or the dermal immune response in restricted lesions in different body regions. Some authors describe that the inflammatory infiltrate in lacaziosis lesions showed a predominance of macrophages followed by CD45RO+, CD4+, and CD8+ T cells; CD57+ natural killer cells; S-100+ cells; and CD20+ B lymphocytes. A 54-year-old man and living in the State of Para, Amazon region, Brazil, was seen with a lesion on the left lower limb, which had started as a small nodular area 18 years ago. The lesion showed progressive growth and disseminated to other parts of the body. Our findings showed that dermal immune response differs depending on the type of lesions and clinical presentation, with presence of CD1a+, FXIIIa+, CD45+, CD4+, CD8+, and S-100+ cells and cytokine profile with expression of interleukin 1 β, tumor necrosis factor α, transforming growth factor β, IL-10, and interferon γ.