Fungus

Chromoblastomycosis

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Chromoblastomycosis, Chromomycosis

  • See Also
  1. Fungal Infections
  2. Fungal Dermatoses
  • Pathophysiology
  1. Subcutaneous, Granulomatous Fungal Infection (deeper than most Fungal Dermatoses)
  2. Found in tropical and subtropical regions
  3. Caused by one of 5 fungal genera (Fonsecaea, Cladophialophora, Exophiala, Phialophora, Rhinocladiella)
    1. Reddish-brown colored soil saprophytes that inhabit rotting wood
  • History
  1. Infection follows Puncture Wound (rotten wood splinter)
  • Findings
  1. Start as small violet, scaly Papule, Nodule or wart-like growths
  2. Typically affects the foot or leg
    1. May affect the hand or wrist in uncommon cases
    2. May be associated with distal extremity swelling
  3. Lesions spread as nearby satellite lesions over the course of years
    1. Lesions may cluster and appear similar to cauliflower
    2. Skin lesions may ulcerate
  • Labs
  1. Potassium Hydroxide (KOH Preparation)
    1. Reddish-brown clustered fungal cells (sclerotic bodies, muriform bodies, Copper pennies, medlar bodies)
  • Management
  1. Mild Chromoblastomycosis
    1. Surgical excision with 5-mm margins
    2. Other treatment options include laser and Cryosurgery
    3. Imiquimod (Aldara)
  2. Moderate to Severe Chromoblastomycosis
    1. May be used in combination with local destructive procedures above
    2. Itraconazole 100 to 200 mg (up to 400 mg) daily for 12 to 24 (up to 36 months)
      1. May be used in combination with Terbinafine
  • Complications
  1. Scarring may impair limb functioning
  2. Cutaneous Squamous Cell Carcinoma
  3. Lymphedema
  4. Bacterial superinfection
  • References
  1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 204
  2. Kurien (2024) Chromoblastomycosis, Stat Pearls +PMID: 29261968 [PubMed]