Paracoccidioidomicose: freqüência, morfologia e patogênese de lesões tegumentares
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Data
2007-10-01
Autores
Marques, Silvio Alencar [UNESP]
Cortez, Daniela Barros
Lastoria, Joel Carlos [UNESP]
Camargo, Rosangela M. Pires de [UNESP]
Marques, Mariângela Esther Alencar [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Sociedade Brasileira de Dermatologia
Resumo
FUNDAMENTOS: Paracoccidioidomicose é micose sistêmica de alta prevalência no Brasil. As lesões orocutâneas são de importância para o diagnóstico e acompanhamento clínico. OBJETIVO: Quantificar e qualificar a presença de lesões cutâneas em pacientes com paracoccidioidomicose e correlacionar com forma clínica e gravidade dos casos. MÉTODOS: Realizou-se estudo clínico observacional de série de casos, classificados segundo a forma clínica, localização topográfica e morfologia da lesão quando presente. RESULTADOS: Foram estudados 152 pacientes classificados como forma crônica do adulto (87,5%) ou como forma aguda-subaguda, tipo juvenil (12,5%). Lesão cutânea foi identificada em 61,2% dos pacientes. Não houve correlação estatística entre presença de lesão e forma clínica (p=1,000) ou entre presença de lesão e gravidade clínica (p= 0,5607). Houve correlação entre presença de lesão mucosa e a forma clínica crônica do adulto (p<0,001). As lesões localizaram-se no segmento cefálico (47,6%), tronco (14,9%), membro superior (14,9%), membro inferior (21,7%) e região genital (0,7%). As lesões ulceradas (42,8%) e as de padrão infiltrativo (26,6% dos casos), foram predominantes. CONCLUS ÃO: A freqüência de lesões cutâneas e padrão morfológico são úteis ao diagnóstico da paracoccidioidomicose. É incomum a presença de lesão da mucosa oral na forma aguda-subaguda, tipo juvenil.
BACKGROUND: Paracoccidioidomycosis is a highly prevalent systemic mycosis in Brazil. The oral and cutaneous lesions are useful for diagnostic proposals and clinical follow-up. OBJECTIVE: To quantify and qualify skin lesions associated to active paracoccidioidomycosis and to correlate them with the clinical form and severity of cases. METHODS: An observational clinical study of cases was performed. Patients were classified according to the clinical form, topographic distribution and morphology of skin lesions. RESULTS: A total of 152 patients classified as chronic form (adult type) (87.5%) or acute-subacute form (juvenile type) (12.5%) were studied. Skin lesion was diagnosed in 61.2% of patients. There was no statistical correlation between presence of skin lesion and clinical form (p=1.000), nor between skin lesion and severity of disease (p=0.5607). There was statistical correlation between mucosal lesion and adult patients (p <0.001). The lesions were on the cephalic segment (47.6%), trunk (14.9%), upper limbs (14.9%), lower limbs (21.7%) and genital region (0.7%). The ulcerated lesions (42.8%) and infiltrative (26.6%) lesions prevailed. CONCLUSION: The frequency of skin lesions and their morphology are useful for diagnosis of paracoccidioidomycosis. Oral lesions in the acute-subacute form (juvenile type) are not common.
BACKGROUND: Paracoccidioidomycosis is a highly prevalent systemic mycosis in Brazil. The oral and cutaneous lesions are useful for diagnostic proposals and clinical follow-up. OBJECTIVE: To quantify and qualify skin lesions associated to active paracoccidioidomycosis and to correlate them with the clinical form and severity of cases. METHODS: An observational clinical study of cases was performed. Patients were classified according to the clinical form, topographic distribution and morphology of skin lesions. RESULTS: A total of 152 patients classified as chronic form (adult type) (87.5%) or acute-subacute form (juvenile type) (12.5%) were studied. Skin lesion was diagnosed in 61.2% of patients. There was no statistical correlation between presence of skin lesion and clinical form (p=1.000), nor between skin lesion and severity of disease (p=0.5607). There was statistical correlation between mucosal lesion and adult patients (p <0.001). The lesions were on the cephalic segment (47.6%), trunk (14.9%), upper limbs (14.9%), lower limbs (21.7%) and genital region (0.7%). The ulcerated lesions (42.8%) and infiltrative (26.6%) lesions prevailed. CONCLUSION: The frequency of skin lesions and their morphology are useful for diagnosis of paracoccidioidomycosis. Oral lesions in the acute-subacute form (juvenile type) are not common.
Descrição
Palavras-chave
Epidemiologia, Manifestações cutâneas, Membrana mucosa, Micoses, Paracoccidioidomicose, Epidemiology, Mucous membrane, Mycosis, Paracoccidioidomycosis, Skin manifestations
Como citar
Anais Brasileiros de Dermatologia. Sociedade Brasileira de Dermatologia, v. 82, n. 5, p. 411-417, 2007.