Paracoccidioïdomycose localisée au pavillon d’une oreille

Introduction La paracoccidioidomycose est une infection fongique systemique frequente en Amerique latine. Les atteintes cutanees sont frequentes et habituellement multiples, le plus souvent associees a des lesions de la muqueuse oro-pharyngee. La forme cutanee isolee est rare. Observation Nous rapportons un cas de paracoccidioidomycose cutanee isolee de l�oreille chez un homme immunocompetent de 43 ans. La lesion formait un placard partiellement ulcere du pavillon de l�oreille gauche. L�examen mycologique direct, l�examen anatomopathologique et la PCR permettaient de mettre en evidence, dans la lesion cutanee, des levures identifiees comme Paracoccidioides brasiliensis. Discussion Les localisations a l�oreille de la paracoccidioidomycose peuvent etre confondues avec d�autres pathologies tropicales frequentes en region amazonienne, notamment la leishmaniose, la lepre ou la lobomycose. Le caractere unique de cette localisation cutanee faisait discuter son origine primitive ou secondaire. Summary Background Paracoccidioidomycosis is a systemic fungal infection common in Latin America. Cutaneous involvement is frequent and usually affects multiple sites, being most frequently associated with lesions of the oropharyngeal mucosa. The cutaneous form on its own is rare. Patients and methods We report a case of paracoccidioidomycosis isolated from the ear of a 43-year-old immunocompetent man. The lesion consisted of a partially ulcerated plaque on the auricle of the left ear. Direct examination, histopathological examination and PCR revealed the presence in the skin lesion of yeasts identified as Paracoccidioides brasiliensis. Discussion The sites of paracoccidioidomycosis on the ear can be confused with other tropical diseases frequently found in the Amazon region such as leishmaniasis, leprosy and lobomycosis. The absence of any other cutaneous sites in this case raised the question of whether the lesion was of primary or secondary origin.