Chromoblastomycosis

Introduction. 

This is a fungal infection caused by dematiaceous (melanin-pigmented) fungi. It is rare in the US. Cauliflower-like lesions appear on the skin surface at the site of injury and the fungi then invade the local lymphatics; lesions also appear at skin sites served by the infected lymph ducts. Such infections are very difficult to treat and often necessitate surgery or amputation. Care must be taken to distinguish these from actinomycoses (bacterial origin) which may present similar clinical signs.

Summary

• Cause: dematiaceous fungi (e.g. Phialophora)
• Microscopy: diverse septate molds
• Transmission: Wound inoculation
• Symptoms: cauliflower-like ulceration of skin at injury site
• Complications: Invasion of lymphatics; spread along lymph causing lesions on skin
• Pathogenesis: invasion of lymph and skin; ulcering lesions due to immune response
• Treatment: Heat/cryotherapy + itraconazole or terbinafine

Links

• http://www.mycolog.com/23-15_chromoblastomycosis.jpg
• http://www.mold.ph/phialo4.jpg