Eyelid involvement in paracoccidioidomycosis.
OBJECTIVE
To describe a series of patients with eyelid lesions caused by paracoccidioidomycosis and to estimate the prevalence of eyelid involvement in this disease


METHODS
The medical records of 439 patients with paracoccidioidomycosis admitted to our hospital from 1992 to 2002 were reviewed. Age, sex, and clinical forms of the disease were recorded. All patients with eyelid involvement had a skin biopsy positive for paracoccidioidomycosis and were examined by an ophthalmologist with oculoplastic training.


RESULTS
Of 439 patients with acute, subacute, or chronic paracoccidioidomycosis, 11 (2.5%) had eyelid involvement. Active lesions ranged from erythematous patches of madarosis to frank destructive ulcers indistinguishable from malignancies. Healed lesions were characterized by a high degree of fibrosis. Cicatricial changes induced eyelid malpositions (entropion or ectropion) and fusion of eyelid tissues to the globe. Madarosis was a constant finding in the inactive lesions.


CONCLUSIONS
The prevalence of eyelid involvement in paracoccidioidomycosis is low. Isolated active lesions are usually diagnosed as malignant tumors. Cicatricial changes are characterized by a high degree of fibrosis. If not treated, the mycosis can destroy the eyelid.
Cruz
Antonio A V
AA
Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Hospital das Clínicas-Campus, Departamento de Oftalmologia, Ribeirão Preto, São Paulo, Brazil. aavecruz@fmrp.usp.br
Zenha
Fabio
F
Silva
Jose T
JT
Martinez
Roberto
R
D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D002921:Cicatrix / Q000150:complications / Q000382:microbiology; D004483:Ectropion / Q000209:etiology; D004774:Entropion / Q000209:etiology; D005141:Eyelid Diseases / Q000209:etiology; D005143:Eyelids / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000150:complications / Q000473:pathology*