Dermatologic examination and the evolution assessment of the Jorge Lobo's disease among the Caiabi Indians, Central Brazil

Abstract

There are many diseases among the Indians and the dermatologic diseases are very habitual. The UNIFESP/EPM Health Program in Xingu National Park (XNP) verified many of these dermatologic diseases included the Jorge Lobo`s disease that affects particularly the Caiabi Indians. The Jorge Lobo’s disease basically occurs in the Americas and more specifically in the Amazon basin. This is a chronic cutaneous-subcutaneous mycosis with a great cutaneous polymorphism and it can have bacteria infections and malignant (squamous-cell carcinomas). Despite the fact that most of cases are benign, there are cases with a great potential of morbidity. Due the difficulty to isolate the etiologic agent, its natural cycle and transmission epidemiologic network are not much known.This mycosis has many dermatologic presentations: long term stable lesions, multiple lesions with fast development and lesions with recurrent ulcers. The agent virulent factors and the host immunity response are little known mainly to explain the presence of benign or serious poles of the disease. The most part of the divulged knowledge about the clinical characteristics of the disease are based in cases without the evolve aspects. In face of this reality the prevalence of the serious forms and the evolution installation of the lesions haven't been much studied. The Xingu's Caiabi Indians offer a unique situation to the explanation the topics about the natural history of this mycosis. There is a great number the affected Indians with this disease among the ones that went to the Xingu National Park (XNP) about 40 years ago and still live there. The UNIFESP/EPM Health Program in XNP has been developed since 1965 and this population has been examined in different times with the clinical information and photographic register about each case of Jorge Lobo's disease and about other dermatologic diseases. We are going to visit this population and we will do a careful clinical examination, photographic register and obtain the tissue of the cutaneous lesions after the correct information and consent according to the National Ethic Research Committee, and a immunohistochemical study of the host response to the agent will be performed. The data of the 43 patients (24 alive and 19 dead) along 40 years will be studied again. This study will allow a more consistent analysis about the clinical evolution of the Jorge Lobo's disease in the specific Indian population (Caiabi) followed along 40 years and it will permit the characterization of the host immune response in different clinical forms and different evolution.This study has the goal to collaborate with the UNIFESP/EPM Health Program in relation to the other dermatologic diseases during the visit at the XNP. (AU)