Histopathology of cutaneous and mucosal lesions in human paracoccidioidomycosis

Histopatologia de lesões cutânea e mucosa em paracoccidioklomicose humana

ORIGINAL ARTICLES

Histopathology of cutaneous and mucosal lesions in human paracoccidioidomycosis

Histopatologia de lesões cutânea e mucosa em paracoccidioklomicose humana

Fabio Uribe^I; Angela I. Zuluaga^I; Walter León^II; Angela Restrepo^I

^ICorporación para Investigaciones Biológicas (CIB), Hospital Pablo Tobón Uribt, Medellin, Colombia

^IISección de Dermatologia, Hospital Universitário San Vicente de Paul, Medellin, Colombia. Presented at the International Colloquium on Paracoccidioidomycosis, Medellin, Colombia, February 1986

^{Address for reprints}

SUMMARY

Biopsies from cutaneous and mucosal lesions from 40 patients with active paracoccidioidomycosis, were studied histopathologically. All cases exhibited chronic granulomatous inflammation and 38 also presented suppuration; this picture corresponded to the mixed mycotic granuloma (MMG). Pseudoepitheliomatous hyperplasia and the transepidermic (or epithelial) elimination of the parasite, were observed in all cases. In paracoccidioidomycosis elimination takes place through formation of progressive edema, accompained by exocytosis. The edema gives rise to spongiosis, microvesicles and microabscesses which not only contain the fungus but also, various cellular elements.

Cells in charge of the phagocytic process were essentialy Langhans giant cells; PMN's, epithelioid and foreign body giant cells were poor phagocytes. An additional finding was the presence of fibrosis in most biopsies.

Key words: Paracoccidioidomycosis - Histopathology; Mixed mycotic granuloma; Transepithelial elimination of parasites.

RESUMO

Biopsias de lesões cutânea e mucosa de 40 pacientes com paracoccidioidomicose ativa foram estudadas em seu aspecto histopatológico. Todos os casos mostravam inflamação granulomatosa crônica e 38 também apresentavam supuração; este quadro correspondia ao granuloma micótico misto (MMG). A eliminação do parasita ocorre através da formação de edema progressivo, acompanhado por exocitose. O edema evolui a espongiose, microvesículas e microabscesses que não só contém o fungo, mas também vários elementos celulares. As células encarregadas do processo fagocitário eram essencialmente células gigantes de Langhams; polimorfonucleares, células epitelióides e células gigantes de corpos estranhos eram fagócitos pobres. Um achado adicional foi a presença de fibrose na maioria das biópsias.

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ACKNOWLEDGEMENTS

The authors express their sincere appreciation to Dr. Raul Jimenez of the Department for Oral Pathology, School of Dentistry, University of Antioquia, for his kindness in furnishing us with several biopsy specimens for our study. Thanks are also expressed to Maria E. Salazar, M.T., who kindly cooperated with the photographic studies.

• 1. ANGULOORTEGA, A. & POLLAK, L. - Paracoccidioidomycosis. In: BAKER, R. D., ed. - The pathological anatomy of the mycoses. Berlin, Springer Verlag, 1971. p. 507-576.
• 2. BATRES, E.; WOLF, J. E.; RUDOLF, A. H. & KNOWX, J. M. - Transepithelial elimination of cutaneous chromomycosis. Arch. Derm., 114: 1231-1232, 1978.
• 3. CHANDLER, J. A.; KAPLAN, W. & AJELLO, L. - Color atlas and text of the histopathology of mycotic diseases. Chicago, Year Book Medical Publishers, 1980. p. 88-91; 246-252.
• 4. DAHL, M. - Clinical immunodermatology. Chicago, Year Book Medical Publishers, 1981. p. 134.
• 5. De BRITO, T.; FURTADO, S. J.; CASTRO, M. & MANINI, M. - Intraepithelial parasitism in human paracoccidioidomycosis (South American Blastomycosis). Virchows. Arch. path. Anat., 351: 129-138, 1973.
• 6. De BEURMAN, L. & GOUGEROT, H. - Les sporotrichoses. Paris, Felix Alcon, 1912.
• 7. De GRACIANSKY, P. & BROULLE, S. - Sporotrichose. Atlas de Dermatologie. Paris, Librerie Malone, 1952. v. 9, p. 1-6.
• 8. FLEISCHMAN, J. & LEHRER, R. I. - Phagocytic mechanisms in host response. In: HOWARD, D. H., ed. - Fungi pathogenic for humans and animals. Part B.: Pathogenicity and detection. New York, Marcel Deker, 1985. p. 123-149.
• 9. FRANCO, M. F. & MONTENEGRO, M. R. G. - Anatomia patológica. In: DEL NEGRO, G.; LACAZ, C. S. & FIQRILLO, A. M. - Paracoccidioidomycose (Blastomycose Sulamericana). São Paulo, Sarvier, 1982. p. 97-117.
• 10. HIRSCH, B. C. & JOHNSON, W. C. - Concepts of granulomatous inflammation. Int. J. Derm., 23: 90-100, 1984.
• 11. HIRSCH, B. C. & JOHNSON, W. C. - Pathology of granulomatous diseases. Mixed inflammatory granulomas. Int. J. Derm., 23: 585-597, 1984.
• 12. LEVER, P. & SCHAUMBURG-LEVER, G. - Histopathology of the skin. 6th ed. Philadelphia, Lippincott, 1983. p. 346-347. 1980. p. 201-208.
• 13 . MENDES, E - Imunopatoligia. São Paulo, Sarvier, 1980. p. 201-208.
• 14. PINKUS, H. & MEHREGAN, A. H. - A guide to dermatohistopathology. 3rd.ed. New York, Appleton Croft, 1981. p. 247-259.
• 15. URIBE, F.; LEON, W. & VELASQUEZ, J. P. - Modificaciones tisulares a nivel de la piel en algunas micosis. Acta med. colomb., 7: 171-179, 1982.
• 16. URIBE, F.;ZULUAGA, A.; LEON, W. & RESTREPO A. - Aspectos histológicos de la esporotricosis y busqueda del agente etiológico por métodos inmunoenzimáticos. Acta med. colomb., 10: 65-74, 1985.

Address for reprints:

Fabio Uribe, M.D.,

Corporación para Investigaciones Biológicas

Apartado Aéreo 7378

Medellin. Colombia, South America.

Publication Dates

• Publication in this collection
  17 Feb 2011
• Date of issue
  Apr 1987