Histopathology of cutaneous and mucosal lesions in human paracoccidioidomycosis

Uribe, Fabio; Zuluaga, Ángela; León, Walter; Restrepo, Ángela

doi:10.1590/s0036-46651987000200005

Cited by 22 publications

(15 citation statements)

References 4 publications

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“…3 Multibudding yeast elements are the characteristic structure, and finding them establishes the diagnosis. 7 The present case was unique from a cytologic standpoint in that the cervical paracoccidiodomycosis was identified in a Papanicolaou smear. No other primary focus of paracoccidioidomycosis was found.…”

Section: Discussionmentioning

confidence: 80%

Paracoccidioides brasiliensis in a Postpartum Pap Smear

Sheyn

Mira²,

Thompson³

2001

Acta Cytologica

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Section: Discussionmentioning

confidence: 80%

Paracoccidioides brasiliensis in a Postpartum Pap Smear

Sheyn

Mira²,

Thompson³

2001

Acta Cytologica

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“…From one to a dozen narrow-necked buds of uniform or variable sizes may arise from the mother cells. Sometimes, the yeast cells appear in chains and have single buds, elongated distorted cells, and a number of other forms (195,240 (113,114,319). Occasionally, however, exceedingly small, pseudohyphal, and hyphal forms of P. brasiliensis are seen in tissue sections (155,171,240).…”

Section: Microbiologymentioning

confidence: 99%

Paracoccidioidomycosis: an update

1993

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This review summarizes knowledge on various aspects of paracoccidioidomycosis. Mycelial propagules, chlamydospores, and arthroconidia exhibit thermal dimorphism; arthroconidia are infectious in animals and, by electron microscopy, appear well provided for survival. The mycelial-to-yeast-phase transformation requires a strict control of glucan synthesis probably mediated by membrane enzymes. Hormonal influences on the transformation of the fungus (mycelium or conidium to yeast phase) have been demonstrated. Estrogen-binding proteins have been detected in the fungal cytosol, and during the transformation novel proteins are produced as a result of estradiol incorporation. Clinical forms have been better defined on the basis of better experimental models. Emphasis has been placed on the lungs as the portal of entry and on the existence of silent pulmonary infections. A specific Paracoccidioides brasiliensis antigen, the 43-kDa glycoprotein (Gp43), has been identified, characterized, and cloned. This has led to improved reproducibility and specificity of serologic tests. The depression of cell-mediated immune responses has been associated with severe disease in humans and in the experimental host. T-cell subsets in patients' tissues were characterized by means of monoclonal antibodies, and a reduced CD4/CD8 ratio was demonstrated. This has been related to alterations in lymphokine and tumor necrosis factor production, production of antigen-antibody complexes, etc. Amphotericin B has provided effective therapy. Azole derivatives have also improved prognosis and facilitated therapy. Itraconazole is presently the drug of choice, yet incapacitating sequelae (mainly pulmonary fibrosis) still constitute major problems.

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“…No que diz respeito ao último grupo, um número crescente de microrganismos vem sendo citado no contexto da ETEP, incluindo fungos, bacté-rias, protozoários e até mesmo clamídias. 15 Parasitas dispostos em uma epiderme hiperplásica em associação com células inflamatórias, especialmente neutrófi-los, formando microabscessos e/ou histiócitos, sugerindo um evento de ETEP, são especialmente observados em infecções micóticas granulomatosas e supurativas, tais como cromomicose (CM) e paracoccidioidomicose (PM), 16,17 micoses profundas de maior prevalência no Brasil. Entretanto, isso não corresponde exatamente ao cenário microscópico da DJL, caracterizado por um infiltrado inflamatório granulomatoso rico em histiócitos, em que neutrófilos são apenas observados na derme superficial de lesões ulceradas.…”

Section: Discussionunclassified

Eliminação transepidérmica de parasitas na doença de Jorge Lobo

Miranda

Costa

Bittencourt³

et al. 2010

An. Bras. Dermatol.

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Resumo: FUNDAMENTOS: A eliminação transepidérmica de parasitas (ETEP) tem sido pouco estudada na doença de Jorge Lobo. OBJETIVOS: Identificar aspectos morfológicos da ETEP na doença de Jorge Lobo. MÉTODOS: Recortes de biópsias de doença de Jorge Lobo emblocados em parafina foram corados pela hematoxilina-eosina e examinados. Considerou-se como ETEP, exclusivamente, a presença de parasitas em estruturas epidérmicas. RESULTADOS: Foram incluídas no estudo 40 biópsias de 37 pacientes (31 homens e seis mulheres, média de idade 51,03 anos, variação 29-80 anos) realizadas em um período de 37 anos , das quais foram obtidos 511 cortes (média de 12,77 cortes por caso, variação 2-39 cortes por caso). Observou-se ETEP em 110/511 (21,52%) e não se observou em 401/511 cortes (78,48%) (p < 0,0001). Em relação aos pacientes (37), em 15 se verificaram aspectos consistentes com ETEP (40,5%), ao passo que, em 22 deles (59,5%), isso não foi observado (p > 0,05). Os parasitas dispunham-se em infundíbulos hiperplásicos, formando catênulas, ou como unidades isoladas, associados ou não a células inflamatórias. CONCLUSÕES: Aspectos consistentes com ETEP, embora observados em número estatisticamente não significante de pacientes da amostra (p > 0,05), sugerem que, na doença de Jorge Lobo, o fenômeno, invariavelmente, ocorra através do epitélio infundibular. Estudos futuros serão necessários para avaliar sua eventual importância na epidemiologia da micose. Palavras-chave: Doença granulomatosa crônica; Micoses; Micoses/patologia; Pele Abstract: BACKGROUND: Few studies have focussed on the transepidermal elimination of parasites in Jorge Lobo's disease (lobomycosis). OBJECTIVE: To identify the morphological features of the transepidermal elimination of parasites in lobomycosis. METHODS: Sections were obtained from paraffin-embedded biopsy specimens of patients with lobomycosis and stained with hematoxylin-eosin for microscopic examination. Only the presence of parasites in epidermal structures was considered to constitute transepidermal elimination. RESULTS: Forty biopsies from 37 patients were included in the study (31 males and 6 females). The mean age of patients was 51.03 years (range 29-80 years). Biopsies performed over a period of 37 years were used, from which 511 sections were obtained (a mean of 12.77 sections per case; range 2-39 sections per case). Transepidermal elimination of parasites was found in 110/511 (21.52%) and was absent in 401/511 sections (78.48%) (p<0.0001). Features consistent with the phenomenon were found in 15/37 patients (40.5%) and were absent in 22/37 (59.5%) (p>0.05). Parasites in the epidermis were detected within hyperplastic infundibula, either connected in chains or as isolated units, associated or not with inflammatory cells. CONCLUSION: Features consistent with transepidermal elimination of parasites were found in a statistically nonsignificant number of patients in the sample (p>0.05), suggesting that in Jorge Lobo's disease, this phenomenon invariably occurs through the infundibular epithelium. Fut...

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Histopathology of cutaneous and mucosal lesions in human paracoccidioidomycosis

Cited by 22 publications

References 4 publications

Paracoccidioides brasiliensis in a Postpartum Pap Smear

Paracoccidioides brasiliensis in a Postpartum Pap Smear

Paracoccidioidomycosis: an update

Eliminação transepidérmica de parasitas na doença de Jorge Lobo

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