title: Enlarged, painful cervical and axillary lymph nodes in chronic paracoccidioidomycosis.
abstract: BACKGROUND
  Paracoccidioidomycosis is an important medical and social problem mainly in rural areas of Brazil, because of the high incidence of the diseases, its long clinical evolution, frequent recurrences and sequels leading to anatomical and functional incapacities.
  
  
  METHODS
  We present a 73-year-old patient with paracoccidioidomycosis showing significant lymph node manifestations, which are only common in children and teenagers.
  
  
  CONCLUSIONS
  Paracoccidioidomycosis may have a long incubation period, and it can be diagnosed outside of the endemic regions, where it was acquired. Thus, all dermatologists should maintain a high index of suspicion, especially in unusual cases of extensive lymph node enlargement in the elderly patients.
authors.affiliation: Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
authors.forename: Débora Braga
authors.initials: DB
authors.lastname: de Pinho
authors.affiliation: Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
authors.forename: Thaís
authors.initials: T
authors.lastname: da Costa Neves
authors.affiliation: Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
authors.forename: Lívia Ribeiro
authors.initials: LR
authors.lastname: Célem
authors.affiliation: Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Quintella
authors.affiliation: Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
authors.forename: Rosângela
authors.initials: R
authors.lastname: Rodrigues
authors.affiliation: Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
authors.forename: Marcia
authors.initials: M
authors.lastname: Ramos-E-Silva
keywords: itraconazole; lymph nodes; lymphadenopathy; mucous membranes; mycosis; ulcer