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Oral Paracoccidioidomycosis affecting women: A systematic review
Matheus de Castro Costa1, Milena Moraes de Carvalho1, Felipe Fornias Sperandio2,3
1Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil.
Abstract:
Paracoccidioidomycosis (PCM) is an infection caused by fungi of the genus Paracoccidioides and is marked by a strong predilection for men; nevertheless, some women have had developed PCM and have presented oral involvement by the disease.
Objectives:
To review all published cases until August 2020 of oral PCM in women, with emphasis on the presence of systemic changes, deleterious habits (tobacco and alcohol) and oral manifestation features through a systematic review.
Methods:
Observational studies (both prospective and retrospective) and case reports indexed in the Embase, PubMed, Scopus, Web of Science and LIVIVO databases were selected by two reviewers in a two-phase process following the pre-established PICOS criteria.
Results:
Twenty-five studies met the eligibility criteria and were selected for qualitative synthesis, of which 72 participants were enrolled. Brazilian White women between 40 and 50 years were the most affected and social history revealed them to be housewives or rural workers. Fifteen women (33.3% of the informed cases) presented any systemic change at the time of PCM diagnosis, namely pregnancy, HIV infection and/or depression. Moriform stomatitis was predominant and affected preferentially the gingivae and alveolar processes in the form of a single painful lesion. Most patients were treated with sulfamethoxazole + trimethoprim or itraconazole.
Conclusions:
Oral PCM in women is rare; some cases showed systemic changes at the time of PCM diagnosis, namely HIV infection, pregnancy and depression. New studies should be conducted to elucidate the influence of systemic alterations on the development of oral PCM in women.
Insights
Oral Paracoccidioidomycosis (PCM) is rare in women. Some cases present with systemic changes like HIV infection, pregnancy, or depression, highlighting the need for further research into these influences.
Area of Science:
- Mycology
- Infectious Diseases
- Oral Medicine
Background:
- Paracoccidioidomycosis (PCM) is a fungal infection predominantly affecting men.
- Oral involvement in women with PCM is uncommon but documented.
- Understanding oral PCM in women requires examining systemic factors and clinical presentations.
Purpose of the Study:
- To systematically review published cases of oral PCM in women up to August 2020.
- To analyze systemic changes, lifestyle factors (tobacco, alcohol), and oral manifestations in affected women.
- To synthesize current knowledge on this rare condition.
Main Methods:
- Systematic review of observational studies and case reports.
- Databases searched: Embase, PubMed, Scopus, Web of Science, LIVIVO.
- Two reviewers applied PICOS criteria for study selection.
Main Results:
- Twenty-five studies involving 72 women were included.
- Most affected: Brazilian White women aged 40-50, housewives or rural workers.
- Systemic changes (HIV, pregnancy, depression) present in 33.3% of cases; moriform stomatitis was the predominant oral lesion.
Conclusions:
- Oral PCM in women is rare, with systemic conditions like HIV, pregnancy, and depression noted at diagnosis.
- Further research is needed to understand the impact of systemic alterations on oral PCM development in women.
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