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Review
. 2018 Jul-Aug;93(4):495-506.
doi: 10.1590/abd1806-4841.20187321.

Chromoblastomycosis: an etiological, epidemiological, clinical, diagnostic, and treatment update

Arival Cardoso de Brito  1   2   3 , Maraya de Jesus Semblano Bittencourt  1
Affiliations
Review

Chromoblastomycosis: an etiological, epidemiological, clinical, diagnostic, and treatment update

Arival Cardoso de Brito et al. An Bras Dermatol. 2018 Jul-Aug.

Abstract

Chromoblastomycosis is a chronic, granulomatous, suppurative mycosis of the skin and subcutaneous tissue caused by traumatic inoculation of dematiaceous fungi of the family Herpotrichiellaceae. The species Fonsecaea pedrosoi and Cladophialophora carrionii are prevalent in regions where the disease is endemic. Chromoblastomycosis lesions are polymorphous: verrucous, nodular, tumoral, plaque-like, and atrophic. It is an occupational disease that predominates in tropical and subtropical regions, but there have been several reports of cases in temperate regions. The disease mainly affects current or former farm workers, mostly males, and often leaving disabling sequelae. This mycosis is still a therapeutic challenge due to frequent recurrence of lesions. Patients with extensive lesions require a combination of pharmacological and physical therapies. The article provides an update of epidemiological, clinical, diagnostic, and therapeutic features.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1
Types of CBM lesions according to Carrión (1950). Initial CBM lesion
Figure 2
Figure 2
Types of CBM lesions according to Carrión (1950). Nodular
Figure 3
Figure 3
Types of CBM lesions according to Carrión (1950). Verrucous
Figure 4
Figure 4
Types of CBM lesions according to Carrión (1950). Plaque
Figure 5
Figure 5
Types of CBM lesions according to Carrión (1950). Tumoral
Figure 6
Figure 6
Types of CBM lesions according to Carrión (1950). Cicatricial
Figure 7
Figure 7
CBM lesions according to severity criteria. A - mild; B - moderate; C - severe
Figure 8
Figure 8
Differential diagnosis. A - nocardiosis; B - verrucous paracoccidioidomycosis; C - lupus vulgaris; D: squamous cell carcinoma; E - verrucous leishmaniasis; F - verrucous sporotrichosis; G - Jorge Lobo’s disease
Figure 9
Figure 9
Direct mycologic examination. A - muriform bodies; B - Muriform bodies and dematiaceous hyphae
Figure 10
Figure 10
A - F. pedrosoi colony; B - F. pedrosoi microculture; C - C. carrionii colony; D - C. carrionii microculture
Figure 11
Figure 11
Histological features. A - Pseudoepitheliomatous hyperplasia, hyperparakeratosis, and dermis with edema and granulomatous inflammatory infiltrate (Hematoxylin & eosin, x40); B - Muriform cells in the stratum corneum with transdermal elimination(Hematoxylin & eosin, x400); C - Suppurated granuloma with muriform bodies inside giant cells (Hematoxylin & eosin, x400); D - Muriform cells and septated hyphae in abscess (Fite-Faraco staining) x100
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