Paracoccidioidomycosis (South America blastomycosis) is a deep mycosis caused by the Paracoccidioides brasiliensis , that has been considered the most frequent systemic mycosis in Latin America. Mulberry-like ulcers on the oral mucous membranes are one of the earliest manifestations of the disease. The infection may remain subclinical, localized or may occasionally disseminate. Hematogenous dissemination of paracoccidioidomycosis to abdominal lymph nodes, spleen, liver, adrenal glands, skin, or brain can result in life-threatening complications. When the disease manifests with signs and systemic symptoms without its classics features, a initial confusion may occur among clinicians, leading to delayed diagnosis and treatment of the disease and its associated comorbidities. The aim of this study is to report three cases of oral paracoccidoidomycosis which presented different clinical features from the typical clinical presentation described in literature: (1) Man, 58 years old, presenting with oral manifestation of single painless ulcer with elevated edges, on the lateral border of the tongue, similar to a squamous cell carcinoma and associated with Addison’s disease due to adrenal impairment; (2) Woman, 29 years old, with a painless ulcer in philtrum, HIV-positive sorology and no other manifestations of related diseases; (3) Man, 56 years old, presenting with the classic frame of Paracoccidioidomycosis: disseminated disease in oral mucosa, raspberry-pattern lesions and impairment of pulmonary parenchyma in an alcoholic homeless patient.
Conflict of interest: None declared.