Paracoccidioidomycosis (PCM) is an infection caused by fungi of the genus Paracoccidioides and is marked by a strong predilection for men; nevertheless, some women have had developed PCM and have presented oral involvement by the disease. Objectives: To review all published cases until August 2020 of oral PCM in women, with emphasis on the presence of systemic changes, deleterious habits (tobacco and alcohol) and oral manifestation features through a systematic review. Methods: Observational studies (both prospective and retrospective) and case reports indexed in the Embase, PubMed, Scopus, Web of Science and LIVIVO databases were selected by two reviewers in a two‐phase process following the pre‐established PICOS criteria. Results: Twenty‐five studies met the eligibility criteria and were selected for qualitative synthesis, of which 72 participants were enrolled. Brazilian White women between 40 and 50 years were the most affected and social history revealed them to be housewives or rural workers. Fifteen women (33.3% of the informed cases) presented any systemic change at the time of PCM diagnosis, namely pregnancy, HIV infection and/or depression. Moriform stomatitis was predominant and affected preferentially the gingivae and alveolar processes in the form of a single painful lesion. Most patients were treated with sulfamethoxazole + trimethoprim or itraconazole. Conclusions: Oral PCM in women is rare; some cases showed systemic changes at the time of PCM diagnosis, namely HIV infection, pregnancy and depression. New studies should be conducted to elucidate the influence of systemic alterations on the development of oral PCM in women.

中文翻译：

---

影响女性的口腔副球孢子菌病：系统评价

副球孢子菌病 (PCM) 是由副球孢子菌属真菌引起的感染，其特点是对男性有强烈的嗜好性；尽管如此，一些女性已经发展为 PCM 并且口腔受累。目的：回顾 2020 年 8 月之前所有已发表的女性口腔 PCM 病例，重点是通过系统评价存在全身变化、有害习惯（烟草和酒精）和口腔表现特征。方法：在 Embase、PubMed、Scopus、Web of Science 和 LIVIVO 数据库中索引的观察性研究（前瞻性和回顾性）和病例报告由两名审查员按照预先制定的 PICOS 标准在两阶段过程中选择。结果：25 项研究符合资格标准并被选为定性综合，其中72人参加。40 至 50 岁的巴西白人女性受影响最大，社会历史表明她们是家庭主妇或农村工人。15 名女性（占知情病例的 33.3%）在 PCM 诊断时出现任何全身性变化，即怀孕、HIV 感染和/或抑郁症。Moriform 口腔炎占主导地位，并以单一疼痛病变的形式优先影响牙龈和牙槽突。大多数患者接受磺胺甲恶唑+甲氧苄啶或伊曲康唑治疗。结论：女性口腔 PCM 很少见；一些病例在 PCM 诊断时出现全身性变化，即 HIV 感染、妊娠和抑郁。应该进行新的研究来阐明全身性改变对女性口腔 PCM 发展的影响。40 至 50 岁的巴西白人女性受影响最大，社会历史表明她们是家庭主妇或农村工人。15 名女性（占知情病例的 33.3%）在 PCM 诊断时出现任何全身性变化，即怀孕、HIV 感染和/或抑郁症。Moriform 口腔炎占主导地位，并以单一疼痛病变的形式优先影响牙龈和牙槽突。大多数患者接受磺胺甲恶唑+甲氧苄啶或伊曲康唑治疗。结论：女性口腔 PCM 很少见；一些病例在 PCM 诊断时出现全身性变化，即 HIV 感染、妊娠和抑郁。应该进行新的研究来阐明全身性改变对女性口腔 PCM 发展的影响。40 至 50 岁的巴西白人女性受影响最大，社会历史表明她们是家庭主妇或农村工人。15 名女性（占知情病例的 33.3%）在 PCM 诊断时出现任何全身性变化，即怀孕、HIV 感染和/或抑郁症。Moriform 口腔炎占主导地位，并以单一疼痛病变的形式优先影响牙龈和牙槽突。大多数患者接受磺胺甲恶唑+甲氧苄啶或伊曲康唑治疗。结论：女性口腔 PCM 很少见；一些病例在 PCM 诊断时出现全身性变化，即 HIV 感染、妊娠和抑郁。应该进行新的研究来阐明全身性改变对女性口腔 PCM 发展的影响。