Clinical and demographic profile of chromoblastomycosis in a referral service in the midwest of São Paulo state (Brazil)

Abstract

Chromoblastomycosis is one of the most frequent deep mycoses found in rural populations. This cross-sectional, retrospective and descriptive study was conducted with cases of chromoblastomycosis diagnosed throughout 20 years. A higher prevalence was observed among White male rural workers, with an average age of 59.69 years. Median time between onset of symptoms and diagnosis was 156 months. Lesions were predominantly located on the lower limbs; 34% of cases reported previous trauma. The most common associated symptoms were itching, pain and burning sensation. Mycological examination was positive in 91% of cases and Fonsecaea pedrosoi was the most prevalent etiologic agent.

Chromoblastomycosis: clinical experience and review of literature

“…In all series reviewed, F. pedrosoi and C. carrionii were the most common . Chromoblastomycosis is primarily of the tropics and subtropics.…”

“…Ten isolates were identified by phenotypic and molecular analysis and demonstrated that nine isolates from Mexico and Venezuela were 100% homologous and one showed a small genetic distance . In a Brazilian series, the average age of 59.69 years, and a median time between onset of symptoms and diagnosis was 156 months …”

Cromoblastomicosis: características clínicas y microbiológicas de una enfermedad desatendida

“…En Perú sólo se han reportado entre 10 a 49 casos, número similar a lo descrito en Argentina y E.U.A; pero menos que en Venezuela y México. Sin embargo, es en Brasil donde se ha comunicado el mayor número de casos (500 publicados) 9 , con una prevalencia estimada de uno de cada 196.000 habitantes 10 . La presentación clínica de ambos casos fue en las extremidades superiores, en contraste con un estudio realizado en Brasil, donde la presentación más frecuente fue en los miembros inferiores (81,5%) 7 .…”

“…Para ello se debe prestar mucha atención en la recolección, debiendo realizarse de lesiones cutáneas cubiertas de puntos negros. La muestra deberá evaluarse mediante examen microscópico directo con hidróxido de potasio al 20% 4 , una técnica sencilla, económica y ampliamente utilizada como tamizaje 10 . El cultivo micológico como estándar de oro, es confirmatorio y permite estudiar a la especie fúngica tanto en la macroscopia como en microscopia.…”

Acral manifestations of fungal infections

“…After inoculation, the disease progresses slowly and spontaneous resolution is not observed unless treated. 87,88 In general, the disease remains localized to the area of the initial infection or neighboring skin, but lymphatic and hematogenous dissemination may occur, causing metastatic lesions. Annular lesion resolves centrally with scarring.…”