Objetivo: Relatar um caso clínico de lesões cutâneas e intraorais na paracoccidioidomicose generalizada. Descrição do caso: Paciente do sexo masculino, 44 anos, apresentando perda de peso havia 4 meses, tosse e febre frequente, com hipótese diagnóstica de tuberculose, procurou atendimento odontológico por conta de lesão bucal ulcerada assintomática de aspecto granulomatoso. O paciente apresentava marcha lenta, sinais de debilidade orgânica e fraqueza, além de uma lesão descamativa em sobrancelha esquerda. Após avaliação de exames de imagem, sorológicos e hematológicos, optou-se pela realização da biópsia incisional da lesão a nível ambulatorial. O laudo histopatológico das colorações em H/E e a Histoquímica em Grocott tiveram diagnóstico conclusivo para paracoccidioidomicose. Devido à debilidade do paciente, o mesmo foi encaminhado para tratamento a nível hospitalar no Departamento de Medicina Tropical do Hospital Professor Edgar Santos da Universidade Federal da Bahia. Atualmente encontra-se sem lesões, porém ainda continua em tratamento. Conclusão: A paracoccidioidomicose é uma micose sistêmica grave, que representa um sério problema em países da America Latina, principalmente o Brasil. É necessário que os profissionais estejam atentos as características clínicas da doença para um correto diagnóstico e encaminhamento para instituição do tratamento adequado. A participação do Cirurgião-Dentista e do Estomatologista é de suma importância para estabelecimento do diagnóstico diferencial desta lesão e encaminhamento para o centro médico especializado, sempre mantendo contato com os profissionais envolvidos no tratamento.

The dental surgeon plays a fundamental role in the early diagnosis of oral leishmaniasis, since oral mucosa may be the primary site of the disease manifestation. This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had mucocutaneous leishmaniasis with oropharyngeal involvement confirmed by laboratory tests. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dental surgeon. In two reported cases, there were unspecific biopsy results. The multidisciplinary approach plays an important role in orofacial leishmaniasis diagnosis and treatment. Leishmaniasis should be investigated in case of atypical and persistent lesions in patients from endemic regions. This recommendation may avoid diagnosis delays and decrease dissemination of the disease.

Dentists play a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had leishmaniasis diagnosis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dentist. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination.