title: Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment.
abstract: Chromoblastomycosis is one of the most frequent infections caused by melanized fungi. It is a subcutaneous fungal infection, usually an occupational related disease, mainly affecting individuals in tropical and temperate regions. Although several species are etiologic agents, Fonsecaea pedrosoi and Cladophialophora carrionii are prevalent in the endemic areas. Chromoblastomycosis lesions are polymorphic and must be differentiated from those associated with many clinical conditions. Diagnosis is confirmed by the observation of muriform cells in tissue and the isolation and the identification of the causal agent in culture. Chromoblastomycosis still is a therapeutic challenge for clinicians due to the recalcitrant nature of the disease, especially in the severe clinical forms. There are three treatment modalities, i.e., physical treatment, chemotherapy and combination therapy but their success is related to the causative agent, the clinical form and severity of the chromoblastomycosis lesions. There is no treatment of choice for this neglected mycosis, but rather several treatment options. Most of the patients can be treated with itraconazole, terbinafine or a combination of both. It is also important to evaluate the patient's individual tolerance of the drugs and whether the antifungal will be provided for free or purchased, since antifungal therapy must be maintained in long-term regimens. In general, treatment should be guided according to clinical, mycological and histopathological criteria.
authors.affiliation: Departamento de Saude Comunitária e Serviço de Infectologia do Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, PR, Brazil. queiroz.telles@uol.com.br
authors.forename: Flavio
authors.initials: F
authors.lastname: Queiroz-Telles
authors.forename: Phillippe
authors.initials: P
authors.lastname: Esterre
authors.forename: Maigualida
authors.initials: M
authors.lastname: Perez-Blanco
authors.forename: Roxana G
authors.initials: RG
authors.lastname: Vitale
authors.forename: Claudio Guedes
authors.initials: CG
authors.lastname: Salgado
authors.forename: Alexandro
authors.initials: A
authors.lastname: Bonifaz
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001203:Ascomycota / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D002862:Chromoblastomycosis / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D006229:Hand Dermatoses / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007868:Leg Dermatoses / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D008297:Male
chemical_list: D000935:Antifungal Agents