PMC3247095_01
Disseminated plaque-like, ulcerated skin lesions. It was presented in: A, the face, forehead, nasal and oral mucosa; B, abdomen; C, genital area and fingers; D, right leg; E, laryngoscopy showing granulomatous lesion in the laryngeal mucosa..
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F1
A 46-year-old male farmer born in Minas Gerais State, Brazil, presented with disseminated plaque-like, ulcerated skin lesions (Figure 1A-D). Laryngoscopy showed lesions on the pharyngeal, nasal, and laryngeal mucosa (Figure 1E).
Histopathological analysis of a skin biopsy. A, Chronic ulcerative and granulomatous lesion of the skin (H&E stain 200x). B, Yeast spores with birefringent walls and multiple sporulation in the interior of a granuloma (Grocott stain 400x).
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F2
B surface antigen, hepatitis C antibodies, and human immunodeficiency virus (HIV). Biopsy showed granulomatous inflammation, and yeasts with birefringent walls and multiple buds with a rudder's wheel aspect, characteristic of paracoccidioidomycosis (PCM), were seen (Figure 2A and B).