Chromoblastomycosis
Chromoblastomycosis
is primarily a tropical disease caused by multiple species of Fonsecaea,Phialophora,
and Cladophialophora (Cladosporium). The disease occurs
typically on the foot or leg. It appears as papules that develop into scaly, wartlike
structures, usually under the feet. Fully developed lesions have been likened
to the tips of a cauliflower. Extension is by satellite lesions; it is slow and
painless and does not involve the lymphatic vessels. The organisms are found in
the soil of endemic areas, and most infections occur in individuals who work
barefoot.
The outstanding
mycologic feature is the presence of brown-pigmented, thickwalled,
multiseptate, 5- to 12-mm globose structures called muriform bodies on
histologic section. Branching septate hyphae may also be demonstrated in KOH
preparations of scrapings. Cultures grow as dark molds, but may take weeks to
appear and longer for demonstration of haracteristic conidia. Surgery and
antifungal therapy have been used in chromoblastomycosis, but results in
advanced disease are disappointing. Flucytosine or itraconazole have been the
antifungal agents most frequently used.
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