Last Updated: 2020-08-12
- Rudolph 1914
- Lane 1915
- Medlar 1915
Worldwide occurring fungal infection mainly of the lower extremities and hands.
- Worldwide, but mainly found in South America, the south of the USA, Europe and Russia
- Mostly middle-aged men
- Mainly occurring in rural areas
- 6 species of fungi with strong structural similarities:
- Phialophora verrucosa jeanselmii or - gougerotii
- Fonsecae pedrosoi
- Fonsecae compacta
- Botromyces caespitosus
- Cladosporium carrionii
- Rhinocladiella aquaspersa
- The fungi are usually found on wood or plants. Small skin lesions lead to inoculation. In rare cases insect bites may also lead to an infection.
Initially a slightly painful, pruriginous papule, plaque or pustule may appear in the area of the inoculation site. In the course of time, there is a progression in size and the development of erythematous, verruziform, granulomatous, partly ulcerated, crusty nodules. Secondary impetiginizations are observed more frequently.
- Clinical features
- Pathogen detection (myco. smear, biopsy)
- Lower extremity > upper extremity or face
- Especially lower legs, feet, but also hands (gardening)
Mostly chronic course.
- Therapy is often frustrating due to resistance to therapy
- Surgical removal
- Heat therapy
- The therapy should be carried out with both topical and systemic antimycotics!
- for example: Ketoconazole cream (2%)
- Itraconazole p.o. 100-200 mg 1x daily for 6-20 months (success rate approx. 65%)
- Alternative: Fluconazole p.o. 50 mg 1x daily for 14 days
- Alternative: Terbinafine p.o.500 mg 1x daily for 6-12 months
- Alternative: Posaconazole p.o. 400 mg 2x daily
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- Wortman PD. Concurrent chromoblastomycosis caused by Fonsecaea pedrosoi and actinomycetoma caused by Nocardia brasiliensis. Journal of the American Academy of Dermatology 1995;32:390-2.
- Yu R. Successful treatment of chromoblastomycosis with itraconazole. Mycoses 1995;38:79-83.