Cromoblastomicose: relato de 27 casos e revisão da literatura

Abstract

BACKGROUND: Chromoblastomycosis is a subcutaneous mycosis that occurs mainly in rural workers although is being more commonly found among people working in other sectors. The fungus penetrates the skin after its inoculation and the most frequently isolated agent is the Fonsecaea pedrosoi. OBJECTIVES: This study aims at evaluating patients suffering from chromoblastomycosis admitted into the Department of Dermatology of the University Hospital of the Faculty of Medicine of São Paulo State during the ten-year period from 1997 to 2007. METHODS: It is a retrospective study and the medical report cards of 27 Brazilian patients diagnosed as suffering from Chromoblastomycosis from 1997 to 2007 at the Dermatology Department of the Medical School, University of Sao Paulo were reviewed. The following items were analyzed: previous therapeutic approaches; treatment implemented by the group; length of time between the appearing of the lesion and diagnosis; age; gender; profession; origin; site of lesions; isolated agents found in culture and histopathology. RESULTS: Twenty two patients were from the state of Sao Paulo whereas the others came from the states of Bahia and Rondonia. 37% of them were rural workers. Men were more frequently infected (85%). Lesions were more commonly found on the lower limbs (59.2%). In 52% of the cases the isolated agent was the dematiaceous fungus Fonsecaea. pedrosoi. Biopsies showed sclerotic bodies in 92.5% of the cases. CONCLUSION: Data found are in accordance with medical literature on the subject. The disease had been previously studied in our institution in 1983 by Cucé et al. This present study is the second retrospective one about the characteristics of patients suffering from chromoblastmycosis which has been published in indexed medical literature in the state of Sao Paulo. Keywords: Chromoblastomycosis; Epidemiology; Fungi Resumo: FUNDAMENTOS: A cromoblastomicose é uma micose subcutânea que acomete principalmente homens trabalhadores rurais, sendo cada vez mais observada em outras atividades profissionais. O fungo penetra na pele após inoculação, e o agente mais frequentemente isolado é a Fonsecaea pedrosoi. OBJETIVOS: Este estudo visa a avaliar os pacientes com cromoblastomicose admitidos no departamento de dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo no período de 1997 a 2007. MÉTODOS: É um estudo retrospectivo, utilizando a revisão de prontuários, e inclui 27 pacientes. Analisaram-se os tratamentos prévios e os atuais instituídos, o tempo entre o aparecimento das lesões e o diagnóstico, a idade, o gênero, a profissão, a procedência, a localização das lesões e os agentes isolados em cultivo. RESULTADOS: Vinte e dois pacientes eram procedentes do estado de São Paulo. Os demais eram procedentes da Bahia e Rondônia. A maioria dos pacientes estudados eram trabalhadores rurais (37%). Os homens foram os mais acometidos (85%). A maior parte dos pacientes apresentava lesões nos membros inferiores (59,2%). Em 52% dos casos foi isolado ...

A case of extensive chromoblastomycosis from North India

“…Irrespective of the causative fungus, characteristic brown, thick-walled, globe-shaped, multi-septate, muriform sclerotic bodies, 4–12 μm in diameter represent the single most important diagnostic feature. Various workers have reported demonstration of sclerotic bodies in 80–90% cases and our results of direct microscopy concur these findings (Correia et al ., 2010, Sharma et al ., 1999). In our case, we could visualize characteristic sclerotic cells and brown pigmented, septate, hyphal elements as well which are not reported previously and is a unique feature.…”

Topical Application of Imiquimod as a Treatment for Chromoblastomycosis

“…Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis endemic in some tropical and subtropical areas that is caused by a group of dematiaceous fungi [1]. Fonsecaea pedrosoi is the most frequent etiological agent.…”

Workloads and occupational accidents in a rural environment

“…Scientific evident ground this result; some mycoses and fungal diseases such as chromoblastomycosis are more common among rural workers. [19][20] The main cause of chromoblastomycosis is plant manipulation, made possible by contact with etiological agents dispersed in the rural environment, in the soil, decaying vegetation and animals, also possibly acquired when handling agricultural machinery. Such lesions are mainly observed on the lower limbs, especially among those who walk barefoot, though to a lesser extent, they can also affect other regions of the body.…”

“…Such lesions are mainly observed on the lower limbs, especially among those who walk barefoot, though to a lesser extent, they can also affect other regions of the body. [19][20] The chemical loads observed in this study were mainly related to pesticides, widely used in agriculture. [21][22][23] Hence, farmworkers are exposed to chemicals when handling such products and/ or when coming into contact with contaminated plantations, or even when only physically close to other people who apply the product.…”