RESUMO
Paracoccidioidomycosis (PCM) is an infection caused by the dimorphic fungus Paracoccidioides brasiliensis, which has a predilection for hot and humid places; thus, this disease has a particularly high incidence in Brazil. Children, adolescents, and adults can be affected by acute/subacute or chronic PCM. To describe the clinical-pathological characteristics and treatment of a case of chronic PCM oral lesion. The oral examination of a 57-year-old male patient revealed moriform stomatitis on the perioral region (irregular shape), lips vermilion, and continuity with the jugal mucosa. After an incisional biopsy, the anatomopathological analysis confirmed the diagnosis of PCM. The patient was referred to a reference center for tropical diseases and treated with 400mg sulfamethoxazole and 80mg trimethoprim twice a day. Since some adverse effects were observed, the treatment was switched to 100mg of itraconazole twice a day. The follow-up examination revealed accelerated healing of the oral lesions and reduction of the inflammatory process. Stomatologists play a key role in the identification of PCM oral lesions and referral for adequate treatment by an infectious disease specialist. (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Manifestações Bucais , Paracoccidioidomicose , Diagnóstico , FungosRESUMO
ABSTRACT Objective: radiotherapy can lead to different adverse effects in the oral epithelial cells. This article aimed to address the main oral manifestations associated with radiotherapy of head and neck neoplasms, highlighting the importance of the dental practitioners' participation within the skilled multidisciplinary personnel to treatment. Methods: Research was conducted in the PubMed, Lilacs, SciELO, and Google Scholar databases using the keywords "head and neck radiotherapy", "oral manifestations'', and "head and neck neoplasm". Eighteen out of 533 articles published between 2015 and 2022 were selected after duplicates removal and eligibility criteria application. Results: xerostomia, hyposalivation, trismus, dysgeusia, dysphagia, dentin hypersensitivity, fungal and viral infections, radiation caries, osteoradionecrosis, mucositis, periodontal alterations, and tooth development abnormalities were the most frequently reported oral effects of radiotherapy. Conclusions: The participation of dentists in the multidisciplinary team that treats patients with head and neck cancers is fundamental since several oral complications of radiotherapy are observed. Dentists can prevent, reduce and treat some detrimental effects whether the patient is followed-up since the beginning of radiotherapy.
RESUMO Objetivo: A radioterapia pode levar a diferentes efeitos adversos nas células epiteliais orais. Este artigo teve como objetivo abordar as principais manifestações bucais associadas à radioterapia de neoplasias de cabeça e pescoço, destacando a importância da participação do cirurgião-dentista na equipe multidisciplinar apta ao tratamento. Métodos: foi realizada uma busca nas bases de dados PubMed, Lilacs, SciELO e Google Acadêmico utilizando as palavras-chave "radioterapia cabeça e pescoço", "manifestações orais" e "neoplasma de cabeça e pescoço". Dezoito dos 533 artigos publicados entre 2015 e 2022 foram selecionados após a remoção das duplicatas e aplicação dos critérios de elegibilidade. Resultado: xerostomia, hipossalivação, trismo, disgeusia, disfagia, hipersensibilidade dentinária, infecções fúngicas e virais, cárie de radiação, osteorradionecrose, mucosite, alterações periodontais, e anormalidades do desenvolvimento dentário foram os efeitos orais da radioterapia mais relatados. Conclusão: A participação dos dentistas na equipe multidisciplinar que atende pacientes com câncer de cabeça e pescoço é fundamental, pois são observadas diversas complicações bucais da radioterapia. Os dentistas podem prevenir, reduzir e tratar alguns efeitos deletérios se o paciente for acompanhado desde o início da radioterapia.