Silva Cléverson O, Almeida Aroldo Dos Santos, Pereira Alessandro Antônio Costa, Sallum Antônio Wilson, Hanemann João Adolfo Costa, Tatakis Dimitris N
Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, Campinas, SP, Brazil.
J Periodontol. 2007 Jul;78(7):1229-34. doi: 10.1902/jop.2007.060490.
Paracoccidioidomycosis, a deep mycosis endemic in parts of Latin America, often presents with oral lesions involving the gingiva. Nevertheless, the periodontal literature is devoid of references to oral paracoccidioidomycosis. The purpose of this study was to characterize the gingival involvement in oral paracoccidioidomycosis and to contrast clinical and histopathologic diagnosis of the disease. Differential diagnosis and management of oral paracoccidioidomycosis were reviewed.
From January 1995 to October 2006, the files of the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, were reviewed to identify cases referred because of a clinical diagnosis of oral paracoccidioidomycosis. Data collected included patient demographics (age, gender, race, and occupation), clinical information (oral lesion location), and histopathologic diagnosis.
Forty-six cases were identified, and 34 were histopathologically confirmed as paracoccidioidomycosis. Of the remaining 12 cases, one-half were diagnosed as either carcinoma or dysplastic leukoplakia. Of the 34 confirmed paracoccidioidomycosis cases, 45% presented with multiple site involvement, whereas the gingiva/alveolar process was the most prevalent site overall (52%). The gingiva/alveolar process was the most prevalent site in both multiple and single site cases. The majority of patients were men (88%), white (75%), and in their fourth decade of life (47%). Statistical analysis revealed that patients with gingival/alveolar process involvement were demographically indistinguishable from those without.
Oral paracoccidioidomycosis has a strong predilection for the gingiva, whereas patients with gingival lesions do not differ from patients lacking such involvement. Early diagnosis of gingival/oral lesions may prevent life-threatening complications of this mycosis.
副球孢子菌病是一种在拉丁美洲部分地区流行的深部真菌病，常表现为累及牙龈的口腔病变。然而，牙周病学文献中没有关于口腔副球孢子菌病的记载。本研究的目的是描述口腔副球孢子菌病中牙龈受累的特征，并对比该疾病的临床诊断和组织病理学诊断。对口腔副球孢子菌病的鉴别诊断和治疗进行了综述。
回顾1995年1月至2006年10月阿尔费纳斯联邦大学牙科学院口腔病理学实验室的档案，以确定因临床诊断为口腔副球孢子菌病而转诊的病例。收集的数据包括患者人口统计学信息（年龄、性别、种族和职业）、临床信息（口腔病变部位）和组织病理学诊断。
共确定46例病例，其中34例经组织病理学确诊为副球孢子菌病。其余12例中，一半被诊断为癌或发育异常性白斑。在34例确诊为副球孢子菌病的病例中，45%表现为多部位受累，而牙龈/牙槽突是总体上最常见的部位（52%）。牙龈/牙槽突在多部位和单部位病例中都是最常见的部位。大多数患者为男性（88%）、白人（75%），年龄在40岁左右（47%）。统计分析显示，牙龈/牙槽突受累患者在人口统计学上与未受累患者无差异。
口腔副球孢子菌病对牙龈有强烈的偏好，而有牙龈病变的患者与没有此类病变的患者并无不同。牙龈/口腔病变的早期诊断可能预防这种真菌病危及生命的并发症。
