title: Chromoblastomycosis in children and adolescents in the endemic area of the Falcón State, Venezuela.
abstract: The present paper describes 22 cases of chromoblastomycosis (CBM) caused by Cladophialophora carrionii in children and adolescents (2-19 years old). The patients were seen between 1992 and 2004 and all resided in a CBM endemic area in the semi-arid zone of the Falcón state, Venezuela. Twelve of the 22 patients (54.55%) had close relatives who also had CBM and 19 (86.36%) were male. Lesions consisted of erythematous papules with desquamation or squamous plaques (0.12-14.19 cm in diameter), located primarily on the upper limbs (77.27% of patients). Thirteen of the patients were treated with topical 5-fluorouracil (5-FU; 1% cream), seven with topical ajoene (0.5% gel) and two had electrodesiccation and/or fulguration. Two patients who did not respond to 5-FU were treated with oral itraconazole (100 mg/day for 1 month). Complete clinical and mycological remission was achieved in 17/20 (85%) of the patients treated with 5-FC, ajoene and electrodesiccation and/or fulguration. In addition, similar results were obtained with the two patients who received itraconazole therapy. These cases emphasize the importance of early diagnosis in difficult-to-treat mycotic diseases such as CBM. By early intervention we were able to employ topical treatment with a minimum of adverse effects to achieve a high percentage of favorable therapeutic responses. The patients were thus able to avoid the evolution of the chronic, deforming and incapacitation clinical manifestations associated with CBM.
authors.affiliation: Centro de Investigaciones Biomédicas, Universidad Nacional Experimental Francisco de Miranda, Coro, Estado Falcón, Venezuela. maperez@reacciun.ve
authors.forename: M
authors.initials: M
authors.lastname: Pérez-Blanco
authors.forename: R
authors.initials: R
authors.lastname: Hernández Valles
authors.forename: L
authors.initials: L
authors.lastname: García-Humbría
authors.forename: F
authors.initials: F
authors.lastname: Yegres
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001203:Ascomycota / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D002862:Chromoblastomycosis / Q000188:drug therapy* / Q000382:microbiology; D004220:Disulfides / Q000627:therapeutic use; D004564:Electrocoagulation; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005782:Gels / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D012074:Remission Induction; D013454:Sulfoxides; D016896:Treatment Outcome; D014687:Venezuela
chemical_list: D000935:Antifungal Agents; D004220:Disulfides; D005782:Gels; D007166:Immunosuppressive Agents; D013454:Sulfoxides; D017964:Itraconazole; C048980:ajoene; D005472:Fluorouracil