Chromoblastomycosis Caused byPhialophora richardsiae

Abstract

Chromoblastomycosis is a chronic fungal disease of the skin and subcutaneous tissues caused by a group of dematiaceous (black) fungi. The most common etiologic agents are Fonsecaea pedrosoi and Cladophialophora carrionii, both of which can be isolated from plant debris. The infection usually follows traumatic inoculation by a penetrating thorn or splinter wound. Several months after the injury, painless papules or nodules appear on the affected area; these papules then progress to scaly and verrucose plaques. We report a case of chromoblastomycosis caused by Phialophora richardsiae, which has been rarely associated with chromoblastomycosis. The case involved a 43-year-old male, who for the past 2 months had noted an erythematous, pustulous plaque that was somewhat dark brown in color on his right shin; the plaque also had intermittent purulent discharge and crust formation. On histopathological examination, chronic granulomatous inflammation and sclerotic cells were seen. The tissue fungus culture grew out the typical black fungi of P. richardsiae, which was confirmed by polymerase chain reaction. The patient has been treated with a combination of terbinafine and itraconazole for 3 months with a good clinical response. (Ann Dermatol 22(3) 362∼366, 2010)

Pleurostomophora richardsiae – An Insidious Fungus Presenting in a Man 44 Years After Initial Inoculation: A Case Report and Review of the Literature

“…Pseudoepitheliomatous hyperplasia with hyperkeratosis and parakeratosis and sclerotic bodies are seen on histopathology (1,5). One case of P richardisae presenting in this way was recently reported (6). Eumycotic mycetomas are midway in the spectrum of disease between phaeohyphomycosis and chromoblastomycosis.…”

Disseminated phaeohyphomycosis with hepatic artery and portal vein thrombosis caused by Pleurostomophora richardsiae in a liver transplant recipient: A case report

“…2 Cases of chromoblastomycosis typically presented with subcutaneous verrucous, ulcerated, or crusted lesions and eumycotic mycetoma, which are tumor-like lesions with draining sinus tracts and fungal grains that are caused by P richardsiae. 3,9 Subcutaneous P richardsiae infections can occur in healthy people and in people with immunocompromised conditions, such as those having diabetes mellitus, having posttransplantation status, taking immunosuppression therapy, or taking chemotherapy. 3,10 Invasive infections caused by P richardsiae were usually observed in immunocompromised patients (Table 1).…”

Mycetoma‐like chromoblastomycosis: a diagnostic dilemma

“…A case of disseminated Phaeohyphomycosis because of Exophiala spinifera during pregnancy was reported by Ricardo et al, and a case of concurrent mycetoma and chromoblastomycosis was reported by Murthy et al, but a mycetoma‐like presentation of chromoblastomycosis is yet to be reported. It is said that chromoblastomycosis and pheohyphomycosis represent two poles of a spectrum of disease caused by pigmented fungi . So, we assume that the spectrum of diseases caused by dematiaceous fungi has no strict boundries, and a mycetoma‐like presentation may be induced by F. pedrosoi during immunosuppression.…”