Last updated: January 2024
Also known as: Chromomycosis, Cladosporiosis, Verrucous dermatitis, Fonseca’s disease, Pedroso’s disease.
What is chromoblastomycosis?
Chromoblastomycosis is a long-term or chronic fungal infection of the skin and tissue underneath the superficial layer of the skin (called the subcutaneous tissue).
Who gets chromoblastomycosis?
Adult male agricultural workers are most often affected, but the condition has occasionally been reported in children.
It is more common in rural, tropical, and subtropical areas of the world.
Individuals at increased risk of developing chromoblastomycosis include those who are employed in outdoor settings in rural areas (e.g., those working on farms or involved in selling farm products, lumberjacks, farmers, miners, rural area workers).
The condition tends to present more severely in those with a suppressed or compromised immune system.
What causes chromoblastomycosis?
The fungi that cause chromoblastomycosis tend to be found on wood or bark and in the soil. These tend to enter the skin through a penetrating injury (i.e., a splinter, nail, or similar mechanism).
There are six fungi that are responsible for the vast majority of cases:
- Fonsecaea pedrosoi
- Fonsecaea compacta
- Fonsecaea monophora
- Phialophora verrucosa
- Cladophialophora carrionii (formerly Cladosporium carrionii)
- Rhinocladiella aquaspersa
What does chromoblastomycosis look like?
Chromoblastomycosis is characterised by slow growing, scaly, cauliflower-like (verrucous) lumps. Lesions may clear at the centre forming a ring-like area with a raised border. Surrounding smaller lesions (satellites) may develop around the site from scratching.
The lesions can appear anywhere on the body, but the most affected areas are the feet, legs and arms.
How is chromoblastomycosis diagnosed?
The diagnosis is usually made after taking a sample from the lesions for fungal scraping, a skin biopsy or tissue culture.
How is chromoblastomycosis treated?
Treatment options will vary depending on the individual and their needs.
Treatment may include oral antifungals, such as itraconazole, terbinafine, posaconazole.
Other treatment options may include:
- Heat therapy (thermotherapy)
- Freezing using liquid nitrogen (cryotherapy)
- Surgical removal
What is the likely outcome of chromoblastomycosis?
Small or solitary lesions have a high chance of being treated successfully with small residual scarring. Chronic and extensive disease is more difficult to treat and relapse is common.
The lesions may become secondarily infected with bacteria. The appearance of the lesions associated with chromoblastomycosis can be quite distressing.
In very rare cases, the long-term or chronic lesions develop a type of skin cancer within, called squamous cell carcinomas (SCCs).
Dr Ramez Barsoum & Dr Heba Jibreal | January 2024 |
Dr Ramez Barsoum & Dr Heba Jibreal | February 2020 |