Sarcoid-like lesions in Paracoccidioidomycosis: immunological\nfactors
A 30-year-old woman complained of redness and pimples on the nose for 6 months. She had\nan infiltrated erythematous plaque with papules, pustules and telangiectasia all over\nthe nasal area (). Histopathology showed\nsuperficial and deep tuberculoid inflammatory infiltrate without caseous necrosis,\nconsistent with granulomatous rosacea. Fungi and acid fast-bacilli resistant staining\nnegative.\nThe disease progressed despite the rosacea treatment. The plaque became less defined and\nlarger (). There were four new\ninfiltrated erythematous-brownish sarcoidosis-like plaques on the left and right\neyebrows, on the right temporal region and on the left jaw ( and )\nThe investigation was extended to possible granulomatous infectious diseases. Chest\nX-ray was normal, PB serology, syphilis serology, Montenegro reaction and tuberculin\ntest (PPD) were non-reactive. The histology report was sustained after new biopsies\n().\nAfter l year of follow-up, the patient complained of throat pain. In the oral cavity\nthere was a slightly verrucous lesion with fine granulation tissue and bleeding points\nsimilar to strawberry-like stomatitis ().\nIn the middle of mixed inflammatory infiltrate there were some thick-walled spores with\ndouble contour and multiple budding, compatible with PB ( and ). After treatment, the\npatient achieved clinical cure.