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.
Metastasis is defined as a neoplastic lesion originating from another primary tumor,
with which it is no longer in contact. Cutaneous metastases result from lymphatic
embolization, hematogenous or contiguous dissemination or also direct implantation
during surgical procedures. In women, the tumor most likely to metastasize to skin is
breast cancer, which may manifest as papulonodular neoplastic lesions. We report the
case of a 66 years old female patient, presenting papulonodular lesions13 years after
the initial treatment with surgery and chemotherapy for a cancer of the left
breast.
A 24-year-old male patient, who underwent kidney transplant six years ago due to
Lupus nephritis, for the last two years presented asymptomatic erythematous scaly
plaques on the abdomen and areas exposed to light. Post-transplantation
immunosuppressive medications included prednisone, mycophenolate sodium and
sirolimus. The histopathologic features were typical for epidermodysplasia
verruciformis. Epidermodysplasia verruciformis is a rare autosomal recessive
genodermatosis with increased susceptibility to specific strains of cutaneous human
papilloma virus. The term ''acquired epidermodysplasia verruciformis'' was recently
introduced to the literature and describes epidermodysplasia verruciformis occurring
in patients with impaired cell-mediated immunity. We report an additional case
associated to immunosuppression after kidney transplantation.
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