Chromoblastomycosis due to Fonsecaea monophora

Keywords: chromoblastomycosis, Fonsecaea, itraconazole, cryotherapy

Abstract

Chromoblastomycosis is an implantation mycosis of worldwide distribution caused by saprophytic dematiaceous fungi, mainly from the genera Fonsecaea, Phialophora, Cladophialophora and Rhinocladiella. It manifests as slowly growing erythematous, scaly, verrucous plaques, especially on the extremities.

We present the case of a 61-year-old female patient who presented erythematous plaques on upper limbs that started after trauma. 

The mycological study and pathological anatomy led to the diagnosis of chromoblastomycosis due to Fonsecaea, and molecular techniques identified Fonsecaea monophora, the first confirmed case of this species in our country.

She was treated with itraconazole 200 mg/day associated with cryotherapy, showing a good response.

References

1. Gaviria Giraldo CM, Cardona Castro NM. Esporotricosis y cromoblastomicosis: revisión de la literatura. CES Med [Internet]. 2017 [citado 6 Agosto 2024]; 31(1): 77-91. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-87052017000100079. doi: https://doi.org/10.21615/cesmedicina.31.1.8
2. Ramírez YB, Zúñiga KM, Campos PL. Cromoblastomicosis: características clínicas y microbiológicas. Gestión en Salud y Seguridad Social [Internet]. 2023 [citado 6 Agosto 2024];2(1):34–9. Disponible en: https://www.binasss.sa.cr/ojssalud/index.php/gestion/article/view/197
3. Bassas-Vila J, Fuente MJ, Guinovart R, Ferrándiz C. Cromomicosis. Respuesta al tratamiento combinado con crioterapia y terbinafina. Actas Dermosifiliogr [Internet]. 2014 [citado 6 Agosto 2024];105(2):196–212. Disponible en: http://www.actasdermo.org/es-cromomicosis-respuesta-al-tratamiento-combinado-articulo-S0001731013001051
4. Botello-Mojica HM, Den-Medina LV en, Jaramillo-Ayerbe F, Marulanda-Galvis MA. Cromomicosis, una enfermedad tropical olvidada: revisión de tema a propósito de un caso clínico. Rev Asoc Colomb Dermatol [Internet]. 2021 [citado 6 Agosto 2024];29(1):45–55. Disponible en: https://www.researchgate.net/publication/360750154_Cromomicosis_una_enfermedad_tropical_olvidada_revision_de_tema_a_proposito_de_un_caso_clinico

5. Wattiez V, García J, Aquino N, Insaurralde S, Mendoza G, Celias L, et al. Cromomicosis: casuística del Servicio de Dermatología del Hospital Nacional, periodo 1991- 2015. Rev. virtual Soc. Parag. Med. Int [Internet]. 2017 [citado 6 Agosto 2024];4(2):27–33. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2312-38932017000200027&lng=en&nrm=iso&tlng=es. doi: https://doi.org/10.18004/rvspmi/2312-3893/2017.04(02)27-033
6. Aguilar Fernández G, Araújo López PV. Micosis y nocardiosis de implantación: esporotricosis, cromoblastomicosis, micetomas y nocardiosis. Casuística del Laboratorio Central de Salud Pública, Paraguay, período 1997-2019. Rev. Nac. (Itauguá) [Internet]. 2020 [citado 6 Agosto 2024];12(1):1–13. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2072-81742020000100001&lng=en&nrm=iso&tlng=es. doi: https://doi.org/10.18004/rdn2020.0012.01.001-013
7. Guevara A, Ferreira Nery A, de Souza Carvalho Melhem M, Bonfietti L, Messias Rodrigues A, Hagen F, et al. Molecular epidemiology and clinical-laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil. Mycoses [Internet]. 2022 [cited 7 Aug 2024];65(12):1146–58. Available at: https://pubmed.ncbi.nlm.nih.gov/35869803/. doi: 10.1111/myc.13505
8. Queiroz-Telles F. Chromoblastomycosis: A neglected tropical disease. Rev Inst Med Trop Sao Paulo [Internet]. 2015 [cited 7 Aug 2024];57(Suppl 19):46–50. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4711190/. doi: 10.1590/S0036-46652015000700009
Published
2025-01-16
Section
REPORTES DE CASOS