Chromomycosis - Symptoms & Treatment

Chromomycosis is a suppurative, granulomatous mycosis usually confined to skin. The infaction occurs most commonly in tropical or subtropical climates. Verrucous nodules and flattened annular plaques are the most frequently reported skin lesions in chromomycosis, but deep abscesses and cystic lesions have also been reported. The host defense mechanisms in chromoblastomycosis have not been extensively investigated. It can present as ulcerated or granulomatous skin lesions and/or disseminated granulomas within visceral organs. The lesion may also occur in immunocompromised patients. Chromomycosis is caused by traumatic inoculation of a specific group of dematiaceous fungi. It can be caused by many different type of fungi which become implanted under the skin, often by thorns or splinters. The lesions are usually localized to the distal part of the extremities. Rarely these are located on the hands, arms and the buttocks. Both patients have been managed successfully with surgical excision of isolated lesions, and the condition of one of these has been improved but not cured with low-dose ketoconazole therapy. Very few cases of chromomycosis due to Exophiala have been reported, and this is, to our knowledge, the first European case.

Chromomycosis spreads very slowly; it is rarely fatal and usually has a good prognosis, but it can be very difficult to cure. The features of chromoblastomycosis are distinctive enough to consider it an independent clinical entity. The infection should not be confused with mycoses, such as mycetoma or phaeohyphomycosis, caused by other dematiaceous fungi. The disease tends to spread to neighboring healthy skin, forming plaques, which, at times, can involve a whole limb. This condition has a chronic evolutional course that may be associated with development of epidermoid carcinoma. Special stains, such as periodic acid shift, can be used to detect the presence of these fungi in biopsies, impression smears or histological specimens, but this is rarely needed as the pigmented fungi are readily detected in unstained tissues. Most infections begin on the foot or leg, but other exposed body parts may be infected, especially where the skin is broken. Early small, itchy, enlarging papules may resemble dermatophytosis. The disease affects predominantly men. Typical lesions grow slowly over many years and tend to be found on the lower limbs. However, the use of antifungal agents such as itraconazole, which is effective against many fungi including dermatophytes and yeast, should be investigated.

Causes of Chromomycosis

The common causes and risk factor's of Chromomycosis include the following:

• Traumatic inoculation of a specific group of dematiaceous fungi.
• Bottles fungi.
• It can be caused by many different type of fungi which become implanted under the skin, often by thorns or splinters.
• Certain fungal genera .
• Fungi sticks.
• Cladophialophora.

Symptoms of Chromomycosis

Some sign and symptoms related to Chromomycosis are as follows:

• Most infections begin on the foot or leg, but other exposed body parts may be infected, especially where the skin is broken.
• Small, itchy, enlarging papules.
• Hard, dull red or grayish cauliflower-shaped nodular projections may develop in the center of patches.

Treatment of Chromomycosis

Here is list of the methods for treating Chromomycosis:

• Itraconazole is the most effective drug, although not all patients respond.
• Antibiotics may be used to treat bacterial superinfections.
• Chromoblastomycosis may also be cured by prolonged topical application of tolerable heat from pocket warmers.
• Amphotericin B therapy.
• Oral Antifungal Agents treatment is usually continued for at least 1 year.
• Cryosurgery with liquid nitrogen can be used to treat chromoblastomycosis, especially localized lesions.

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