Chromoblastomycosis

Abstract

Chromoblastomycosis is a chronic, subcutaneous mycosis, characterized by verrucous nodular lesions, usually involving the legs and mainly caused by Fonsecaea, Phialophora, and Cladophialophora spp. The characteristic finding on direct examination or biopsy specimen is the presence of fumagoid cells or Medlar bodies. Chromoblastomycosis can be refractory to medical treatment. Therapeutic options include oral itraconazole, terbinafine, or 5-fluocytosine, alone or combined with surgery or cryosurgery.

Case Study: Chromoblastomycosis

“…The diagnosis is confirmed by skin biopsy and fungal culture to isolate the causative organism. A skin biopsy with the presence of fumagoid cells or Medlar bodies is characteristic and confirms the diagnosis of chromoblastomycosis [2].…”

“…Six months of antifungal treatment can improve the condition however, relapse is common [2]. If medical treatment proves insufficient surgical measures may be required.…”

“…Chromoblastomycosis is a chronic subcutaneous mycosis caused by pheoid or dematiaceous fungi with Fonsecaea pedrosoi being the most common causative organism worldwide [1]. Other fungal causes include Fonsecaea compacta, Fonsecaea monophora, Phialophora verrucosa, Cladophialophora carrionii, Rhinocladiella aquaspersa and Exophiala jeanselmei [2]. Traumatic inoculation of the fungi usually occurs from fungi inhabited thorns or splinters of decaying wood and plants.…”

“…Other treatments resulting in variable outcomes and not widely utilized include oral 5-fluocytosine, oral potassium iodide, high dose vitamin D, intravenous amphotericin B and local heat therapy [2].…”

“…Amputation of the lower limb is the last resort if all other treatments have failed [2] Prognosis is improved by utilising a combined regime of Itraconazole and Terbinafine or utilising both surgical and antifungal treatments [4]. Other treatments resulting in variable outcomes and not widely utilized include oral 5-fluocytosine, oral potassium iodide, high dose vitamin D, intravenous amphotericin B and local heat therapy [2].…”