Single ulcers on the tongue dorsum: differential diagnosis between paracoccidioidomycosis and squamous cell carcinoma.

BACKGROUND: Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated. RESULTS: A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis. CONCLUSIONS: Although uncommon, PCM and OSCC should be considered as a diferential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Iincisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.

[Sociodemographic and behavioral factors related to schistosomiasis in a rural village of the sugar cane belt in Pernambuco State, Brazil] / Fatores sócio-demográficos e comportamentais relacionados à esquistossomose em uma agrovila da zona canavieira de Pernambuco, Brasil

Failure of intensive chemotherapy to control schistosomiasis in a highly endemic area of Northeast Brazil led to the hypothesis that sociodemographic and/or behavioral variables could be involved in the persistent transmission. A univariate analysis of such variables in relation to infection by Schistosoma mansoni showed that water contact patterns for recreation and personal hygiene are important risk factors in the area. However, sociodemographic variables were not related to infection, probably because the local population lives under evenly precarious socioeconomic and sanitary conditions. We thus recommend that chemotherapy be combined with other measures like snail control, health education, and improved sanitation and water supply.

[Schistosomiasis epidemiological patterns in a community of small farmers in Pernambuco State, Brazil] / Padrão epidemiológico da esquistossomose em comunidade de pequenos produtores rurais de Pernambuco, Brasil

This article is part of a larger study in which epidemiological and anthropological methods were used to help understand the production and maintenance of schistosomiasis in a small endemic area in Pernambuco State. A cross-sectional study identified several local risk factors for schistosomiasis, quantifying socioeconomic, sanitary, and behavioral variables and then relating them to the prevalence and intensity of schistosomiasis infection. Using univariate analysis, three variables (age group, schooling, and human/water contact) showed significant association with S. mansoni infection. Causal factors and confounding variables were identified through multivariate analysis. Quantitative epidemiological analysis is critically discussed regarding a qualitative ethnographic study in relation to environmental risk situations (contamination and transmission) as well as risk practices (economic and behavioral).