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We assessed minimally invasive punch cytology with maceration (MIPC-M), a simple procedure that uses a 1-mm punch followed by potassium hydroxide maceration and light microscopy, as a field-ready alternative. In a prospective, cross-sectional study (2014\u20132019) across 11 municipalities in the Brazilian Amazon, individuals \u226512 years with clinically suggestive lesions underwent three cytological approaches in parallel\u2014adhesive tape cytology, exfoliative cytology, and MIPC-M\u2014while histopathology served as the reference. Among 27 participants, MIPC-M identified yeast-like structures compatible with the JLD agent in 27\/27 cases, yielding 100% sensitivity (95% CI, 87.2\u2013100) versus histopathology. Adhesive tape and exfoliative cytology detected 3\/27 (11.1%; 95% CI, 3.9\u201328.1) and 1\/27 (3.7%; 95% CI, 0.7\u201318.3) cases, respectively. No adverse events occurred. These data support MIPC-M as a sensitive, rapid, and low-resource diagnostic option for JLD screening in remote settings. Larger studies should estimate specificity, evaluate inter-operator performance, and determine impacts on time-to-diagnosis and surgical management in Amazonian communities.<\/jats:p>","DOI":"10.1556\/1886.2025.00072","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:41:37Z","timestamp":1765536097000},"page":"232-239","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["Minimally invasive punch cytology with maceration for diagnosing Jorge Lobo disease in\u00a0the Brazilian Amazon"],"prefix":"10.1556","volume":"15","author":[{"given":"Alex Panizza","family":"Jalkh","sequence":"first","affiliation":[{"name":"Tropical Medicine Foundation Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil"},{"name":"Graduate Program in Tropical Medicine (PPGMT\/UEA\/FMT-HVD), State University of Amazonas, Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naira Sulany","family":"Oliveira de Sousa","sequence":"additional","affiliation":[{"name":"BIONORTE Graduate Program in Biodiversity and Biotechnology, Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre Sabino","family":"Sisnando","sequence":"additional","affiliation":[{"name":"Tropical Medicine Foundation Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9lia Val\u00e9ria","family":"de Souza Encarna\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Tropical Medicine Foundation Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e1bio Francesconi","family":"do Vale","sequence":"additional","affiliation":[{"name":"Tropical Medicine Foundation Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e1tia Santana","family":"Cruz","sequence":"additional","affiliation":[{"name":"Tropical Medicine Foundation Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ribamar","family":"Araujo","sequence":"additional","affiliation":[{"name":"Tropical Medicine Foundation Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-7499","authenticated-orcid":true,"given":"Jo\u00e3o Vicente Braga","family":"de Souza","sequence":"additional","affiliation":[{"name":"National Institute of Amazonian Research (INPA), Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagen","family":"Frickmann","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany"},{"name":"Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajendranath","family":"Ramasawmy","sequence":"additional","affiliation":[{"name":"Graduate Program in Tropical Medicine (PPGMT\/UEA\/FMT-HVD), State University of Amazonas, Manaus, Brazil"},{"name":"Graduate Program in Basic and Applied Immunology, Federal University of Amazonas (UFAM), Manaus, Brazil"},{"name":"School of Medicine, Nilton Lins University, Manaus, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"B1","series-title":"Ther Clin Risk Manag","doi-asserted-by":"publisher","first-page":"851","DOI":"10.2147\/TCRM.S46251","article-title":"Lobomycosis: epidemiology, clinical presentation, and management options","volume":"10","author":"Francesconi VA","year":"2014","unstructured":"Francesconi VA, Klein AP, Santos AP, Ramasawmy R, Francesconi F. 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