Clinical aspects of previously treated chromoblastomycosis: A case series from Madagascar

Abstract

To describe the clinical aspects of chromoblastomycosis (CBM) presented by patients who had received incomplete antifungal treatment before consultation. Methods: A prospective study of patients with clinically suspected CBM was performed between 2013 and 2018 in the Department of Dermatology at the University Hospital Antananarivo, and during consultation campaigns. Results: Patients develop CBM over a period of more than 10 years, and many will have already received antifungals prescribed by general practitioners before consulting with a dermatologist. Such treatment obviously modifies the clinical presentation. From the 63 CBM patients in this large study, we describe 12 patients who received oral antifungals (terbinafine, griseofulvine, itraconazole, fluconazole) before consultation. The most frequent clinical aspect presented by these patients was cicatricial lesions, which are characteristically smooth and non-elevated, and enlarge by peripheral extension, with atrophic scarring at the center. Conclusion:Our study is the first to show that cicatricial lesions are a clinical aspect presented by CBM patients who received antifungals before presentation.

Identification of Chromoblastomycosis and Phaeohyphomycosis Agents through ITS-RFLP

“…Infections caused by melanized fungi can significantly impact people's quality of life, leading to discomfort, pain, and, in severe cases, disfigurement. Both chromoblastomycosis (CBM) and phaeohyphomycosis (FEO), when affecting the skin and subcutaneous tissues, can be persistent and challenging to treat, often requiring prolonged therapies and, in some cases, surgical interventions [1,8,[22][23][24]. In immunocompromised patients, such as those with HIV/AIDS, uncontrolled diabetes, or transplant recipients, agents causing phaeohyphomycosis can disseminate to internal organs and the central nervous system, posing a severe life-threatening risk [1, 25,26].…”

Identification of Chromoblastomycosis and Phaeohyphomycosis Agents Through ITS-RFLP

“…Infections caused by melanized fungi can significantly impact people's quality of life, leading to discomfort, pain, and, in severe cases, disfigurement. Both chromoblastomycosis (CBM) and phaeohyphomycosis (FEO), when affecting the skin and subcutaneous tissues, can be persistent and challenging to treat, often requiring prolonged therapies and, in some cases, surgical interventions [1,8,[22][23][24]. In immunocompromised patients, such as those with HIV/AIDS, uncontrolled diabetes, or transplant recipients, agents causing phaeohyphomycosis can disseminate to internal organs and the central nervous system, posing a severe life-threatening risk [1, 25,26].…”

Chromoblastomycosis: A case series from Eastern China

“…The lower limbs are the areas of the body that would be most likely to be in contact with fungi contaminated material [ 21 ]. In most series, there has been a predilection for the lower legs [ 2 , 3 , 21 , 22 ]. However, in Australia, the upper limbs were the most affected parts by CBM [ 23 ], which is also observed in our cohort, where the hand, wrist, and forearm were predominantly affected.…”

“…The most frequent clinical aspect of CBM is different according to various reports. However, verrucous lesions [ 21 , 25 , 26 ], nodular lesions [ 25 , 27 ], cicatricial lesions [ 2 ], and plaque-like lesions [ 3 ] are respectively predominant. In our study, plaque lesions were the most common, followed by verrucous lesions.…”

“…Chromoblastomycosis (CBM) is an implantation mycosis, consisting of chronic cutaneous and subcutaneous lesions that develop at the site of previous transcutaneous trauma [ 1 ]. CBM is strongly associated with agricultural activities and the lack of protection, which further underscores the occupational nature of this disease [ 2 ]. It can lead to chronic persistent infections and may cause an incapacity for labor in some severe clinical forms.…”