Paracoccidioidomycosis (PCM), also known as South American blastomycosis, is a fungal infection that can occur as a mouth and skin type, lymphangitic type, multi-organ involvement type (particularly lungs), or mixed type. If there are mouth ulcers or skin lesions, the disease is likely to be widespread. There may be no symptoms, or it may present with fever, sepsis, weight loss, large glands, or a large liver and spleen.The cause is fungi in the genus Paracoccidioides, including Paracoccidioides brasiliensis and Paracoccidioides lutzii, acquired by breathing in fungal spores.Diagnosis is by sampling of blood, sputum, or skin. The disease can appear similar to tuberculosis, leukaemia, and lymphoma Treatment is with antifungals; itraconazole. For severe disease, treatment is with amphotericin B followed by itraconazole, or trimethoprim/sulfamethoxazole as an alternative.It is endemic to Central and South America, and is considered a type of neglected tropical disease. In Brazil, the disease causes around 200 deaths per year. Signs and symptoms
Asymptomatic lung infection is common, with fewer than 5% of infected individuals developing clinical disease.It can occur as a mouth and skin type, lymphangitic type, multi-organ involvement type (particularly lungs), or mixed type. If there are mouth ulcers or skin lesions, the disease is likely to be widespread. There may be no symptoms, or it may present with fever, sepsis, weight loss, large glands, or a large liver and spleen.
Urea, also known as carbamide-containing cream, is used as a medication and applied to the skin to treat dryness and itching such as may occur in psoriasis, dermatitis, or ichthyosis. It may also be used to soften nails.In adults side  effects are generally few. It may occasionally cause skin irritation. Urea works in part by loosening dried skin. Preparations generally contain 5 to 50% urea.Urea containing creams have been used since the 1940s. It is on the World Health Organizations List of Essential Medicines. It is available over the counter. Medical uses
Urea cream is indicated for debridement and promotion of normal healing of skin areas with hyperkeratosis, particularly where healing is inhibited by local skin infection, skin necrosis, fibrinous or itching debris or eschar. Specific condition with hyperkeratosis where urea cream is useful include:

Dry skin and rough skin
Dermatitis
Psoriasis
Ichthyosis
Eczema
Keratosis
Keratoderma
Corns
Calluses
Damaged, ingrown and devitalized nails

Side effects
Common side effects of urea cream are:

Mild skin irritation
Temporary burning sensation
Stinging sensation
ItchingIn severe cases, there can be an allergic reaction with symptoms such as skin rash, urticaria, difficulty breathing and swelling of the mouth, face, lips, or tongue. Mechanism of action
Urea in low doses is a humectant while at high doses (above 20%) it causes breakdown of protein in the skin.Urea dissolves the intercellular matrix of the cells of the stratum corneum, promoting desquamation of scaly skin, eventually resulting in softening of hyperkeratotic areas. In nails, urea causes softening and eventually debridement of the nail plate. References
External links
"Urea". Drug Information Portal. U.S. National Library of Medicine.