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Chromoblastomycosis: an exuberant case *

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ABSTRACT

Chromoblastomycosis is a chronic subcutaneous mycotic infection caused bydematiaceous saprophytic moulds. The most frequently isolated agent is Fonsecaepedrosoi. This article reports a case of a man from the Amazon region in NorthernBrazil who presented with a lesion of 12 months' duration, which gradually increasedin size until covering the majority of his right leg. A successful treatment withitraconazole was performed.

No MeSH data available.


Mycological study: direct examination (a) and microculture chatacterizingFonsecae pedrosoi
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f04: Mycological study: direct examination (a) and microculture chatacterizingFonsecae pedrosoi

Mentions: A 45-year-old male farmer from the state of Amazonas, Northern Brazil, reported the onsetof a lesion on his left leg one year ago, which had an indolent growth until affecting hisentire left leg (Figure 1). The diagnosis ofchromoblastomycosis was confirmed by mycological and histopathological studies (Figures 2 and 3).Clinical and laboratory tests (complete blood count, glycemia, anti-HIV, and urine) werenormal or negative. The patient has been using itraconazole 400mg/day and improved greatlyafter 15 days (Figure 4) Chromoblastomycosis is achronic subcutaneous infection caused by dematiaceous saprophytic moulds. Clinicalmanifestations are polymorphic and, in severe and long-lasting cases, different lesions maybe identified in the same patient: nodules, tumors, plaques, warts, and scars.1 In the case presented herein, verrucousplaques accompanied by ulcers with angulated borders and geometric shapesuggest that the patient had a major role in the extensive disease involvement byscratching the lesion, along with lymphatic dissemination. The remarkable fibrotic process,which was previously considered a defense mechanism against chromoblastomycosis agents, mayresult from the production of high levels of pyridinoline by the mould, which inducescross-linking in tissue collagen fibrils.2,3,4 Therefore, these fibrils are resistant to interstitial collagenase,due to their restricted access to catalytic sites.5 Fibrosis, when occurring concomitantly to a chronic inflammatoryinfiltrate and to a common secondary infection, impairs lymphatic flow. Finally, anarchicaltissue circulation leads to atrophy of skin and soft tissues, causing deformities anddisabilities, such as in the case reported herein.4 This condition is characterized by a higher growth in extension thanin depth. However, such extensive lesions such as those observed in the present case areuncommon.6-9


Chromoblastomycosis: an exuberant case *
Mycological study: direct examination (a) and microculture chatacterizingFonsecae pedrosoi
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4008075&req=5

f04: Mycological study: direct examination (a) and microculture chatacterizingFonsecae pedrosoi
Mentions: A 45-year-old male farmer from the state of Amazonas, Northern Brazil, reported the onsetof a lesion on his left leg one year ago, which had an indolent growth until affecting hisentire left leg (Figure 1). The diagnosis ofchromoblastomycosis was confirmed by mycological and histopathological studies (Figures 2 and 3).Clinical and laboratory tests (complete blood count, glycemia, anti-HIV, and urine) werenormal or negative. The patient has been using itraconazole 400mg/day and improved greatlyafter 15 days (Figure 4) Chromoblastomycosis is achronic subcutaneous infection caused by dematiaceous saprophytic moulds. Clinicalmanifestations are polymorphic and, in severe and long-lasting cases, different lesions maybe identified in the same patient: nodules, tumors, plaques, warts, and scars.1 In the case presented herein, verrucousplaques accompanied by ulcers with angulated borders and geometric shapesuggest that the patient had a major role in the extensive disease involvement byscratching the lesion, along with lymphatic dissemination. The remarkable fibrotic process,which was previously considered a defense mechanism against chromoblastomycosis agents, mayresult from the production of high levels of pyridinoline by the mould, which inducescross-linking in tissue collagen fibrils.2,3,4 Therefore, these fibrils are resistant to interstitial collagenase,due to their restricted access to catalytic sites.5 Fibrosis, when occurring concomitantly to a chronic inflammatoryinfiltrate and to a common secondary infection, impairs lymphatic flow. Finally, anarchicaltissue circulation leads to atrophy of skin and soft tissues, causing deformities anddisabilities, such as in the case reported herein.4 This condition is characterized by a higher growth in extension thanin depth. However, such extensive lesions such as those observed in the present case areuncommon.6-9

View Article: PubMed Central

ABSTRACT

Chromoblastomycosis is a chronic subcutaneous mycotic infection caused bydematiaceous saprophytic moulds. The most frequently isolated agent is Fonsecaepedrosoi. This article reports a case of a man from the Amazon region in NorthernBrazil who presented with a lesion of 12 months' duration, which gradually increasedin size until covering the majority of his right leg. A successful treatment withitraconazole was performed.

No MeSH data available.