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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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