Chromoblastomycosis

Introduction 

Chromoblastomycosis is a chronic progressive subcutaneous mycosis caused by multiple species of pigmented fungi, known as melanized or ‘dematiaceous’ fungi, mainly the Fonsecaea, Phialophora, or Cladosporium species

-the fungi appear as brown, thick-walled, spherical, septal cells in tissues (Medlar bodies or muriform cells) 

-it usually affects older male agricultural workers 

-it typically occurs on the foot or leg, arms or trunk following tissue injury due to trauma  

-it occurs in the Americas, Africa (particularly Madagascar), and South Asia 

Symptoms & Signs 

-the fungus forms thick-walled single cells or cell clusters (sclerotic or muriform bodies), which may transform into papules, scaly, wart-like structures resembling the tips of a cauliflower, and verrucous plaques with satellite lesions 

Diagnosis 

Histology: brown-pigmented, thick double-walled, multiseptate, melanized sclerotic, globose structures called muriform bodies. 

Culture: fungi grow as darkly pigmented black colonies with a downy surface 

Treatment 

Antifungals: Itraconazole,voriconazole, terbinafine, flucytosine, amphotericin Procedures: Cryotherapy, curettage, electrodessication, and surgical excision

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