Cutaneous lesions

Abstract

In paracoccidioidomycosis the cutaneous lesions are important not only because of their high frequency but also because they carry especial diagnostic value and clinical significance. The clinical significance of cutaneous lesions depends on their number, pattern, and location. Multiple lesions of the papulo-acneiform type point toward hematogenous dissemination of P. brasiliensis and reflect the severity of the disease. Cutaneous lesions may originate from preexisting contigous lesions, from the hematogenous dissemination of the fungus or from the direct inoculation of P. brasiliensis into the skin. Cutaneous lesions originating by contiguity arise from lesions in the neighboring mucosa, from fistulization of a lymph node or from osteomyelitis. Paracoccidioidomycosis is a systemic, chronic, and progressive disease which is acquired by the inhalation of P. brasiliensis propagules and later disseminates to the skin where it produces lesions that are one of the major clinical manifestation of this disorder. The predominant cutaneous lesions are those resulting from the cutaneous implantation of the blood-borne fungus.