History:

Paracoccidioidomycosis, also known as South American blastomycosis or Lutz-Splendore-Almeida disease, is caused by P. brasiliensis. The disease is confined to Latin America, with endemic areas in Brazil, Argentina, Colombia, and Venezuela. Up to 90% of affected individuals are men between 29 and 40 years old, predominantly rural workers.

The respiratory tract is the usual portal of entry; from there, hematogenous dissemination to other parts of the body occurs. The chronic form, or adult type, is much more common and generally affects individuals older than 30 years of age. This form is characterized by involvement of the lungs and mucous membranes.  Skin lesions can manifest as crusted papules and nodules, ulcers, or verrucous plaques. They can also exhibit hemorrhagic dots, similar to the lesions in mucous membranes. Primary cutaneous infections are rare.