A case of chromomycosis caused by Fonsecaea pedrosoi and a review of reported cases of dematiaceous fungal infection in Japan

Abstract

We report a case of chromomycosis caused by Fonsecaea pedrosoi that developed in the left buttock of a 63-year-old female farmer. About 4 years ago, the patient developed erythema in the left buttock, which gradually spread. At the first consultation, we noted a well-defined, red-brown, infiltrated erythematous plaque (8 x 6 cm). Histopathological examination revealed a granulomatous lesion, containing sclerotic cells, associated with giant cells in the upper dermis. The causative fungus was difficult to identify due to low conidiogenesis, but was eventually identified by slide culture as F. pedrosoi. Excision and skin graft were performed, and no recurrence has been observed after 2 years. In Japan, 212 cases of dematiaceous fungal infection were reported in the period from 1982 to 2001. The causative fungus was F. pedrosoi in the majority of cases (126/212; 66%), followed by Exophiala jeanselmei (36/212; 19%). Similar incidence of dematiaceous fungal infection was reported in male and female patients. The upper limbs were affected most frequently in both male and female patients. Ten cases were associated with visceral lesions.

Chromoblastomycosis

“…The first Japanese case was described in 1930 by Kano, who reported a female patient with an unusual CBM-like infection in the facial region, caused by Hormiscium dermatitidis (currently Exophiala dermatitidis) (130). Since the first description, several Japanese authors reported ϳ700 cases of CBM infections (130)(131)(132)(133). Several hundred cases have been reported from Mainland China since the first description by Yew in 1951 (134,135).…”

Chromoblastomycosis

“…In Japan about 10 cases of CBM are reported annually. The occurrence rate of individual species in the last two decades of the 20 th century was as follows: F. pedrosoi – 71%, E. jeanselmei – 20%, Phialophora verrucosa – 4.5%, Exophiala dermatitidis – 2% [49]. …”

Chromoblastomycosis in Kerala, India

“…It was first reported from India in 1957 by Thomas et al [1] Other than India and Brazil, Chromoblastomycosis has been reported from Madagascar, Sri Lanka, West Central Africa, Japan, Mexico, Cuba, Dominican Republic, Nepal, Australia, and Venezuela. [2][3][4][5][6][7][8][9][10][11][12][13][14] According to one report, Madagascar represents the most important focus of this fungal disease. [7] Brazil is another country reporting large number of cases.…”