Paracoccidioidomycosis: a series of 66 patients with oral lesions from an endemic area.

Paracoccidioidomycosis (PCM) is the most important systemic mycosis in Latin America. It has been regarded as a multifocal disease, with oral lesions as the prominent feature. To provide useful information concerning the diagnosis and management of the disease, this study describes demographic and clinical data from the medical records of a consecutive series of 66 Brazilian patients from an endemic area, evaluated in a referral centre for oral diagnosis. In this sample of patients, there was a predominance of middle-aged male patients, who were primarily rural workers. Chronic multifocal disease was prevalent, with lesions also detected in the lungs, lymph nodes, skin or adrenal glands. Most of the cases presented with lesions at the gingival mucosa followed by the palate and lips; these conditions occurring in the oral cavity were frequently associated with pain. Importantly, most of the patients sought professional care for oral lesions. The diagnosis was obtained through exfoliative cytology and/or biopsy of the oral lesions. Medical treatment was effective, and there were no mortalities in the sample. The present findings not only confirm the importance of oral lesions in the diagnosis and management of PCM but also illustrate that questions still remain unclear, such as the possibility of direct inoculation of the fungus onto oral tissues.