Marques Sílvio Alencar, Lastória Joel Carlos, Putinatti Maria Stella de M A, Camargo Rosangela Maria Pires de, Marques Mariangela E A
Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Rev Inst Med Trop Sao Paulo. 2008 Jan-Feb;50(1):47-50. doi: 10.1590/s0036-46652008000100010.
The authors report a case of paracoccidioidomycosis misinterpreted as tuberculoid leprosy, both on clinical and histological examination. Sarcoid-like cutaneous lesion as the initial presentation is rare in young patient with paracoccidioidomycosis and can simulate other infectious or inflammatory diseases. On histology, tuberculoid granuloma presented similar difficulties. Treatment with dapsone, a sulfonamide derivative, could have delayed the presumed natural clinical course to the classical juvenile type of paracoccidioidomycosis, observed only 24 months after the patient had been treated for leprosy.
作者报告了一例在临床和组织学检查中均被误诊为结核样麻风的副球孢子菌病病例。在患有副球孢子菌病的年轻患者中,以类肉瘤样皮肤病变作为初始表现较为罕见,且可类似其他感染性或炎症性疾病。在组织学上,结核样肉芽肿也带来了类似的诊断困难。使用氨苯砜(一种磺胺衍生物)进行治疗,可能延误了推测的自然临床病程,使其未发展为典型的青少年型副球孢子菌病,直到该患者接受麻风病治疗24个月后才观察到这种典型病程。