Gingival involvement in oral paracoccidioidomycosis.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Silva
Cléverson O
CO
Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, Campinas, SP, Brazil. silvaco@fop.unicamp.br
Almeida
Aroldo Dos Santos
AS
Pereira
Alessandro Antônio Costa
AA
Sallum
Antônio Wilson
AW
Hanemann
João Adolfo Costa
JA
Tatakis
Dimitris N
DN
D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000382:microbiology* / Q000473:pathology; D005260:Female; D005881:Gingiva / Q000382:microbiology* / Q000473:pathology; D005882:Gingival Diseases / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology / Q000473:pathology; D010229:Paracoccidioidomycosis / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D017678:Sex Distribution