Paracoccidioidomycosis with sarcoid-like cutaneous lesion: A clinicopathological challenge

We describe a case of sarcoid-like cutaneous paracoccidioidomycosis in a 26-year-old male, with a 10-year evolution, wrongly diagnosed as granulomatous rosacea. The correct diagnosis was only possible after the appearance of a new skin lesion with a more typical characteristic of the dermatosis, correlated with anatomopathological, laboratory and imaging exams. The clinical presentation of paracoccidioidomycosis is diverse, and the sarcoid-like form can mimic several chronic granulomatous diseases, such as sarcoidosis, tuberculoid leprosy, leishmaniasis, or tuberculosis. This presentation of cutaneous paracoccidioidomycosis is rare, and its diagnosis depends on the clinicopathological correlation, which can be a challenge for the dermatologist.