Chromoblastomycosis caused by Rhinocladiella aquaspersa: first case report in Guatemala

Porras-López, Carlos; Frías-De-León, María Guadalupe; Arenas, Roberto; Martínez‐Herrera, Erick

doi:10.1016/j.abd.2019.09.014

Cited by 8 publications

(2 citation statements)

References 7 publications

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“…In fact, it was demonstrated that antifungal drugs need to be employed longer than 5 months to eliminate the etiologic agents of CBM. 13,14 On the other hand, patients treated with acitretin and imiquimod healed the lesions in the 5th month of therapy, suggesting that this association was effective at healing skin lesions (Figure 1g) in a short period of time in comparison with classical treatment. Although this association was effective, it is still important to note that first-line drugs, such as itraconazole and terbinafine -combined or not with imiquimodshould be employed as the standard treatment of CBM, especially in chronic and extensive lesions.…”

Section: Discussionmentioning

confidence: 99%

Managing chromoblastomycosis with acitretin plus imiquimod: A case report on the improvement of cutaneous lesions and reduction of the treatment time

Belda

Casolato

Luppi

et al. 2021

The Journal of Dermatology

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is a mycosis that affects the skin and subcutaneous tissues. The etiologic agent is a black yeast that belongs to the Chaetothyriales order and Herpotrichiellaceae family. This fungus lives in the soil and plants of tropical and subtropical countries. In Brazil, the main etiologic agent is Fonsecaea pedrosoi, additionally infections with Exophiala jeanselmei and Exophiala spinifera have been documented. 1 The infection occurs after a contact of the lesioned skin with black yeast.Classical treatment of CBM is performed with itraconazole (200-400 mg/day), that can be associated with terbinafine (250 mg/day). These drugs are administrated for a long period of time, that basically depends on the individual response of the patient. Despite the long course of treatment, some patients do not show improvement of lesions and others exhibit signs of drug intolerance. Physical approaches, such as surgery, cryotherapy, and thermotherapy, 2 can be employed in the treatment; however, the efficacy is limited. On the other side, untreated patients display a progressive growth of the lesions, compromising the affected member. Moreover, patients presenting lesions lasting over years may develop skin carcinomas. Therefore, it is urgent to create new strategies to treat this neglected fungal disease.An interesting approach to treat infectious diseases is to combine drugs; thus, an elevated cure rate has been recorded when immunomodulatory agents were combined with drugs classically used in therapy. 3 Imiquimod, an antitumor agent, is able to stimulate the immune system through the activation of Toll-like receptors, 4 improving the immune response against infectious agents. 5,6 In fact, it has been demonstrated that patients with CBM over a

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Section: Discussionmentioning

confidence: 99%

Managing chromoblastomycosis with acitretin plus imiquimod: A case report on the improvement of cutaneous lesions and reduction of the treatment time

Belda

Casolato

Luppi

et al. 2021

The Journal of Dermatology

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“…Species of the genus Rhinocladiella have been described as less common agents of chromoblastomycosis 31,32 , i.e. R. aquaspersa, R. similis and R. tropicalis 3 .…”

Section: Discussionmentioning

confidence: 99%

Environmental prospecting of black yeast-like agents of human disease using culture-independent methodology

Costa

Silva

Voidaleski

et al. 2020

Sci Rep

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Melanized fungi and black yeasts in the family Herpotrichiellaceae (order chaetothyriales) are important agents of human and animal infectious diseases such as chromoblastomycosis and phaeohyphomycosis. the oligotrophic nature of these fungi enables them to survive in adverse environments where common saprobes are absent. Due to their slow growth, they lose competition with common saprobes, and therefore isolation studies yielded low frequencies of clinically relevant species in environmental habitats from which humans are thought to be infected. this problem can be solved with metagenomic techniques which allow recognition of microorganisms independent from culture. the present study aimed to identify species of the family Herpotrichiellaceae that are known to occur in Brazil by the use of molecular markers to screen public environmental metagenomic datasets from Brazil available in the Sequence Read Archive (SRA). Species characterization was performed with the BLASt comparison of previously described barcodes and padlock probe sequences. A total of 18,329 sequences was collected comprising the genera Cladophialophora, Exophiala, Fonsecaea, Rhinocladiella and Veronaea, with a focus on species related to the chromoblastomycosis. the data obtained in this study demonstrated presence of these opportunists in the investigated datasets. the used techniques contribute to our understanding of environmental occurrence and epidemiology of black fungi. A large number of species of black yeast-like fungi that belong to the ascomycetous order Chaetothyriales in the family Herpotrichiellaceae are renowned as opportunistic pathogens in immunocompetent vertebrate hosts 1,2. Agents are particularly involved in subcutaneous, and systemic or disseminated infections, known as chromoblastomycosis and phaeohyphomycosis, respectively 2-4. These infections are invariably chronic and can be severely mutilating or even fatal. Chromoblastomycosis is a relatively common disease in rural tropical climate zones around the world. This implantation disorder is characterized by the presence of a specialized tissue form of the fungus known as the muriform cell 2,5,6. Infection is hypothesized to take place via traumatic inoculation of environmental material such as plant thorns and/or wood fragments 7,8. Epidemiological data confirmed by studies using selective

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Presence of hyphae in chromoblastomycosis examinations: an enigma to be solved

Carvalho

Calbucci

Lellis

et al. 2021

Anais Brasileiros de Dermatologia

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Chromoblastomycosis caused by Rhinocladiella aquaspersa: first case report in Guatemala

Cited by 8 publications

References 7 publications

Managing chromoblastomycosis with acitretin plus imiquimod: A case report on the improvement of cutaneous lesions and reduction of the treatment time

Managing chromoblastomycosis with acitretin plus imiquimod: A case report on the improvement of cutaneous lesions and reduction of the treatment time

Environmental prospecting of black yeast-like agents of human disease using culture-independent methodology

Presence of hyphae in chromoblastomycosis examinations: an enigma to be solved

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