<\/span><\/h2>\nChromoblastomycosis can be caused by various fungi found in decomposing soil, wood, and plant material.<\/p>\n
the organism<\/span> it is inoculated<\/span> on the skin from a minor injury, for example, a cut with a splinter when barefoot. It is extremely rare in New Zealand, but relatively common in warmer areas like the Pacific Islands.<\/p>\nThe most common organisms<\/span> They are:<\/p>\n\n- Phialophora verrucosa<\/em><\/li>\n
- Fonsecaea pedrosi<\/em><\/li>\n
- Fonsecaea compact<\/em><\/li>\n
- Cladophialophora carrionii<\/em><\/li>\n
- \nRhinocladiella aquaspersa<\/em> (Ramichloridium cerophilum<\/em>)<\/li>\n<\/ul>\n
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<\/span>What are the clinical characteristics of chromoblastomycosis?<\/span><\/h2>\nChromoblastomycosis usually presents as a single injury<\/span> in an exposed place like the foot or the hand.<\/p>\n\n- It begins as a small firm red or gray bump.<\/li>\n
- It grows very slowly: only about 2mm per year.<\/li>\n
- Finally a warty<\/span> dry nodule<\/span> or license plate<\/span> it develops<\/li>\n
- There may be at least a partial clearance with scars in the center of the injury.<\/li>\n
- The affected limb can be enlarged in general (elephantiasis).<\/li>\n
- New lesions can develop in time as the satellites around the first one or the infection can be scratched at a new site.<\/li>\n
- It may not cause discomfort, but it is often very itchy.<\/li>\n
- Rarely, scaly<\/span> cell carcinoma<\/span> (SCC) develops within long-standing chromoblastomycosis.<\/li>\n<\/ul>\n
The infection is sometimes mistaken for other skin conditions, such as:<\/p>\n
\n- Other fungal infections like sporotrichosis\n<\/li>\n
- \nBacterial<\/span> infections like atypical<\/span> mycobacterial infection, tuberculosis, leprosy, and syphilis\n<\/li>\n
- Protozoal infections such as leishmaniasis.\n<\/li>\n
- Squamous cell carcinoma<\/li>\n
- Skin disorders like psoriasis, discoid<\/span> lupus erythematosus.<\/li>\n<\/ul>\n\n
<\/span>Chromoblastomycosis<\/span><\/h5>\n<\/section>\n\n\n
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<\/span>How is chromoblastomycosis diagnosed?<\/span><\/h2>\nHistopathology<\/span> of chromoblastomycosis may show the typical thick-walled dark brown color 'sclerotic<\/span>'cells in the skin biopsy<\/span> confirming the presence of a dematiaceous fungus. It is dark in color due to melanin<\/span> on the walls of the body.<\/p>\nCulture<\/span> in Sabouraud medium with antibiotics at 25\u201330 degrees centigrade, colonies of olive-green to black fungi grow after one or two weeks. Naming the responsible fungus can be difficult. Phaeohyphomycosis is the name given to an infection caused by dematiaceous fungi.<\/p>\n\n\n
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High power view of histology.<\/p>\n
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Cladophialophora carrionii grown on Sabouraud dextrose agar with antibiotics<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>What is the treatment for chromoblastomycosis?<\/span><\/h2>\nRarely, chromoblastomycosis resolves spontaneously leaving a scar<\/span>.<\/p>\nTreatment is difficult and long. It may include:<\/p>\n