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Chromoblastomycosis

Author
Flavio Queiroz-Telles, MD, PhD
Section Editor
Ted Rosen, MD
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

Chromoblastomycosis (also known as chromomycosis) is a chronic, indolent, granulomatous fungal disease caused by the transcutaneous inoculation of propagules (spores) from several species of melanized fungi. Chromoblastomycosis occurs in tropical and subtropical climates and is one of the most common endemic implantation (subcutaneous) mycoses.

The infection begins at the site of inoculation, affects the cutaneous and subcutaneous tissues, and exhibits diverse clinical findings. Early disease often presents as erythematous macules or papules that develop verrucous or hyperkeratotic features (picture 1I). Without treatment, the infection slowly progresses to larger areas of skin involvement with nodular, verrucous, tumoral, plaque, or scar-like morphologies (picture 1A-E). Severe disease can be associated with tissue fibrosis and lymphedema, leading to physical disability (picture 2).

The diverse clinical findings of chromoblastomycosis mimic other infectious or noninfectious diseases. The diagnosis is confirmed through the identification of characteristic fungal elements called muriform cells (also known as sclerotic bodies or Medlar bodies) with a potassium hydroxide preparation or skin biopsy (picture 3).

Although early, small lesions of chromoblastomycosis can be treated with surgical removal, long-term oral antifungal therapy is the treatment of choice for more extensive disease. Severe disease is often refractory to treatment.

The clinical features, diagnosis, and management of chromoblastomycosis will be reviewed here. Several other subcutaneous mycoses are reviewed separately.

                          
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Literature review current through: Sep 2017. | This topic last updated: Jul 28, 2017.
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