Chromoblastomycosis is a predominantly tropical or subtropical fungal disease caused by environmental dematiaceous (dark-pigmented) fungi, most commonly Fonsecaea pedrosoi. Other causes include F. compacta, Cladophialophora carrionii and Phialophora verrucosa. The disease is a cutaneous/subcutaneous mycosis acquired by traumatic inoculation. Consequently, the most commonly affected areas are the foot, ankle and lower leg. Lesions may start several months after the initial injury, and medical attention is often sought several years later.
The initial lesion is a papule. Further papules develop, and coalesce to form irregular plaques. Nodular lesions may produce a characteristic ‘cauliflower’ appearance.
DIAGNOSIS: - is by histopathological examination of infected material, which shows dematiaceous, rounded, thick-walled ‘sclerotic bodies’ with septa at right angles to each other. The aetiological agent is confirmed by culture. Many therapeutic approaches have been explored, including antifungal agents, cryosurgery and surgical excision, alone or in combination, but the optimal therapy is unknown.
The medicines that can be thought of use are:-