title: Gingival involvement in oral paracoccidioidomycosis.
abstract: 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.
authors.affiliation: Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, Campinas, SP, Brazil. silvaco@fop.unicamp.br
authors.forename: Cléverson O
authors.initials: CO
authors.lastname: Silva
authors.forename: Aroldo Dos Santos
authors.initials: AS
authors.lastname: Almeida
authors.forename: Alessandro Antônio Costa
authors.initials: AA
authors.lastname: Pereira
authors.forename: Antônio Wilson
authors.initials: AW
authors.lastname: Sallum
authors.forename: João Adolfo Costa
authors.initials: JA
authors.lastname: Hanemann
authors.forename: Dimitris N
authors.initials: DN
authors.lastname: Tatakis
mesh_terms: 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