Medicine:Chromoblastomycosis
Chromoblastomycosis is a long-term fungal infection of the skin[1] and subcutaneous tissue (a chronic subcutaneous mycosis).[2]
It can be caused by many different types of fungi which become implanted under the skin, often by thorns or splinters.[3] Chromoblastomycosis spreads very slowly. It is rarely fatal and usually has a good prognosis, but it can be very difficult to cure. Several treatment options exist, including medication and surgery.[4]
The infection occurs most commonly in tropical or subtropical climates, often in rural areas.[5]
Signs and symptoms
Cause
Chromoblastomycosis is believed to originate in minor trauma to the skin, usually from vegetative material such as thorns or splinters; this trauma implants the fungus in the subcutaneous tissue. In many cases, the patient will not notice or remember the initial trauma, as symptoms often do not appear for years. Prominent species of fungi that cause chromoblastomycosis are:
- Cladophialophora bantiana causes both cutaneous chromoblastomycosis and systemic phaeohyphomycosis
- Cladophialophora carrionii
- Fonsecaea compacta[7]
- Fonsecaea nubica[8][9]
- Fonsecaea pedrosoi[10][11]
- Phialophora verrucosa[12]
- Rhinocladiella aquaspersa[13][9]
Mechanism
Diagnosis
Prevention
Treatment
Chromoblastomycosis is very difficult to cure. Treatment may include surgical excision for mild cases and long-term antifungal therapy for severe cases.[14] Intraconazole is considered the first line therapy and cure rates range from 15-80%.[9]
- Itraconazole, an antifungal azole, is given orally, with or without flucytosine.
- Alternatively, cryosurgery with liquid nitrogen has also been shown to be effective.
Other treatment options are the antifungal drugs voriconazole,terbinafine,[15] another antifungal azole posaconazole, and heat therapy.
Amphotericin B has also been used.[16]
Photodynamic therapy is a newer type of therapy used to treat Chromoblastomycosis.[17]
Prognosis
Epidemiology
Chromoblastomycosis occurs globally, most commonly in rural areas in tropical or subtropical climates.[5]
It is most common in rural areas between approximately 30°N and 30°S latitude. Over two-thirds of patients are male, usually between the ages of 30 and 50. A correlation with HLA-A29 suggests genetic factors may play a role, as well.[18]
Social and cultural
Chromoblastomycosis is considered a neglected tropical disease, affects mainly people living in poverty, and causes considerable morbidity, stigma, and discrimination.[5]
See also
- List of cutaneous conditions
References
- ↑ "chromoblastomycosis" at Dorland's Medical Dictionary
- ↑ "Chromoblastomycosis". Clin. Dermatol. 25 (2): 188–94. 2007. doi:10.1016/j.clindermatol.2006.05.007. PMID 17350498.
- ↑ "Chromoblastomycosis | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program" (in en). https://rarediseases.info.nih.gov/diseases/1319/chromoblastomycosis.
- ↑ "Chromoblastomycosis | DermNet New Zealand" (in en). https://www.dermnetnz.org/topics/chromoblastomycosis/.
- ↑ 5.0 5.1 5.2 Santos, Daniel Wagner C. L.; de Azevedo, Conceição de Maria Pedrozo E. Silva; Vicente, Vania Aparecida; Queiroz-Telles, Flávio; Rodrigues, Anderson Messias; de Hoog, G. Sybren; Denning, David W.; Colombo, Arnaldo Lopes (August 2021). "The global burden of chromoblastomycosis". PLOS Neglected Tropical Diseases 15 (8). doi:10.1371/journal.pntd.0009611. ISSN 1935-2735. PMID 34383752.
- ↑ Ran Yuping (2016). "Observation of Fungi, Bacteria, and Parasites in Clinical Skin Samples Using Scanning Electron Microscopy". in Janecek, Milos. Modern Electron Microscopy in Physical and Life Sciences. InTech. doi:10.5772/61850. ISBN 978-953-51-2252-4.
- ↑ Attapattu MC (1997). "Chromoblastomycosis--a clinical and mycological study of 71 cases from Sri Lanka". Mycopathologia 137 (3): 145–51. doi:10.1023/A:1006819530825. PMID 9368408.
- ↑ Cateau, Estelle; Cante, Vincent; Garcia Hermoso, Dea; Rodier, Marie-Helene (2014). "Case of Fonsecaea nubica chromoblastomycosis from the French territory of Mayotte". JMM case reports 1 (4). doi:10.1099/jmmcr.0.004218. ISSN 2053-3721. PMID 28663818.
- ↑ 9.0 9.1 9.2 CDC (2026-01-30). "Clinical Overview of Chromoblastomycosis" (in en-us). https://www.cdc.gov/chromoblastomycosis/hcp/clinical-overview/index.html.
- ↑ "Chromoblastomycosis: clinical and mycologic experience of 51 cases". Mycoses 44 (1–2): 1–7. 2001. doi:10.1046/j.1439-0507.2001.00613.x. PMID 11398635.
- ↑ "Rapid identification of Fonsecaea by duplex polymerase chain reaction in isolates from patients with chromoblastomycosis". Diagn. Microbiol. Infect. Dis. 57 (3): 267–72. March 2007. doi:10.1016/j.diagmicrobio.2006.08.024. PMID 17338941.
- ↑ "A case of chromoblastomycosis with an unusual clinical manifestation caused by Phialophora verrucosa on an unexposed area: treatment with a combination of amphotericin B and 5-flucytosine". Br. J. Dermatol. 152 (3): 560–4. March 2005. doi:10.1111/j.1365-2133.2005.06424.x. PMID 15787829.
- ↑ González, Gloria M.; Rojas, O. Carolina; González, José G.; Kang, Yingqian; de Hoog, G. S. (2013-01-01). "Chromoblastomycosis caused by Rhinocladiella aquaspersa". Medical Mycology Case Reports 2: 148–151. doi:10.1016/j.mmcr.2013.08.001. ISSN 2211-7539. PMID 24432242. PMC 3885939. https://www.sciencedirect.com/science/article/pii/S2211753913000444.
- ↑ Kurien, George; Sugumar, Kavin; Sathe, Nishad C.; Chandran, Veena (2026), "Chromoblastomycosis", StatPearls (Treasure Island (FL): StatPearls Publishing), PMID 29261968, http://www.ncbi.nlm.nih.gov/books/NBK470253/, retrieved 2026-05-17
- ↑ "Treatment of chromoblastomycosis with terbinafine: experience with four cases". J Dermatolog Treat 16 (1): 47–51. February 2005. doi:10.1080/09546630410024538. PMID 15897168. https://zenodo.org/record/894429.
- ↑ "Extensive chromoblastomycosis caused by Fonsecaea pedrosoi successfully treated with a combination of amphotericin B and itraconazole". Med. Mycol. 46 (2): 179–84. March 2008. doi:10.1080/13693780701721856. PMID 18324498.
- ↑ Queiroz-Telles, Flavio; de C L Santos, Daniel Wagner (2013-06-01). "Challenges in the Therapy of Chromoblastomycosis" (in en). Mycopathologia 175 (5): 477–488. doi:10.1007/s11046-013-9648-x. ISSN 1573-0832. PMID 23636730.
- ↑ Queiroz-Telles, Flavio; de Hoog, Sybren; Santos, Daniel Wagner C. L.; Salgado, Claudio Guedes; Vicente, Vania Aparecida; Bonifaz, Alexandro; Roilides, Emmanuel; Xi, Liyan et al. (January 2017). "Chromoblastomycosis". Clinical Microbiology Reviews 30 (1): 233–276. doi:10.1128/CMR.00032-16. ISSN 1098-6618. PMID 27856522.
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