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A Journal on Dermatology and Sexually Transmitted Diseases

Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 1998 February;133(1):51-4

language: Italian

Paracoccidioidomycosis. Description of a case

Solaroli C., Aloi F., Becchis G., Zina A., Pippione M.

Università degli Studi - Torino, Dipartimento di Discipline Medico-Chirurgiche, Sezione Dermatologia (Prof. M. Pippione)


A 49-year-old Brazilian man, presented 4 warty papules on the face. The diagnosis of paracoccidioidomycosis was made by histological demonstration of Paracoccidioidomy-cosis brasiliensis in biopsy material and by culture. Laboratory investigations showed pulmonary and cerebral involvement. Following treatment with 200 mg daily oral itraconazole, the cutaneous and pulmonary lesions healed completely in 3 months. Paracoccidioidomycosis is an endemic systemic mycosis in subtropical areas of South and Central America. The patient described represents the sixth case of paracoccidioidomycosis observed in Italy. All patients observed in our countries were coming from an endemic area. The currently accepted portal of entry of paracoccidioidomycosis infection is through the lungs, from which there is a haematogenous and lymphatic dissemination to other organs. The possible outcome of primary cutaneous or mucosal inoculation of paracoccidiodes is discussed. Probably the distinction between juvenile (acute) and adult (chronic) forms of paracoccidioidomycosis is an academic issue. The clinical presentation of the disease is related to different immunopathogenic mechanisms. Clinically, skin lesions of paracoccidioidomycosis are aspecific and may precede systemic symptoms by several months. Biopsies and cultures are essential for making accurate diagnosis in patients coming from South America with unusual dermatoses.

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