Polymorphic Mucocutaneous Lesions on the Face: A Diagnostic Challenge

Area of Science:

• Mycology
• Infectious Diseases
• Dermatology

Background:

• Paracoccidioidomycosis is a systemic fungal infection endemic to Latin America.
• It often presents with polymorphic mucocutaneous lesions, making early diagnosis challenging.

Purpose of the Study:

• To report a case of paracoccidioidomycosis with atypical presentation.
• To emphasize the importance of considering this infection in the differential diagnosis of mucocutaneous lesions.

Main Methods:

• Clinical case presentation of a 50-year-old male.
• Physical examination findings including facial plaques and oral lesions.
• Histopathological examination revealing characteristic yeast morphology.

Main Results:

• The patient presented with a five-month history of progressive facial lesions and oral stomatitis.
• Histopathology confirmed Paracoccidioides spp. with a "mariner's wheel" budding yeast pattern.
• Diagnosis of paracoccidioidomycosis was established based on clinical and histopathological findings.

Conclusions:

• Paracoccidioidomycosis should be considered in patients with unexplained mucocutaneous lesions, especially in endemic areas.
• The characteristic "mariner's wheel" pattern is a key diagnostic feature.
• Prompt diagnosis and treatment are essential for managing this potentially severe fungal infection.