title: Chromoblastomycosis: a clinical and molecular study of 18 cases in Rio de Janeiro, Brazil.
abstract: BACKGROUND
  Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis caused by dematiaceous fungi.
  
  
  METHODS
  We described epidemiological data, clinical presentation, and treatment of 18 cases of CBM diagnosed in Rio de Janeiro, Brazil. Diagnosis was obtained by mycological, histopathological findings demonstrating typical muriform cells with confirmation of isolated by DNA sequencing of the ribosomal internal transcribed spacer.
  
  
  RESULTS
  The majority of patients were male (72.2%) ranging from 39 to 83 years old, farm laborers and construction workers. The duration of disease varied from four months to 32 years. The most common presentations were verrucous form in ten (55.6%) patients, followed by tumoral in three (16.7%) patients, primarily of moderate (55.6%) and severe (38.9%) intensity. Lower (44.4%) and upper limbs (33.3%) were the most affected sites. Fonsecaea pedrosoi isolated from 14 (77.8%), and Cladophialophora carrionii isolated from one case (5.6%). Fifteen patients (83.3%) were treated. Six patients (40%) received oral itraconazole 200-400 mg/day, five patients (33.3%) received oral itraconazole 200-400 mg/day combined with fluconazole 200 mg/day, and four (26.7%) patients were submitted to surgery. The duration of therapy varied from 12 to 48 months. Cure rate was 80% (12/15). No relapse was observed after two years of follow-up.
  
  
  CONCLUSIONS
  Success was due to attending a center with specialized clinical care, laboratory support, and pharmaceutical care.
authors.affiliation: Laboratório de Dermatologia Laboratório de Micologia Laboratório de Anatomia Patológica, Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Brazil. marcelle.figueiredo@gmail.com
authors.forename: Marcelle de F
authors.initials: Mde F
authors.lastname: Mouchalouat
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Gutierrez Galhardo
authors.forename: Rosely Maria
authors.initials: RM
authors.lastname: Zancopé-Oliveira
authors.forename: Paulo Cezar
authors.initials: PC
authors.lastname: Monteiro Fialho
authors.forename: Janice Mery C
authors.initials: JM
authors.lastname: de Oliveira Coelho
authors.forename: Patrícia Morais
authors.initials: PM
authors.lastname: Silva Tavares
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Francesconi do Valle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D000946:Antigens, Fungal / Q000235:genetics; D001203:Ascomycota / Q000235:genetics / Q000302:isolation & purification*; D001938:Brazil / Q000453:epidemiology; D002862:Chromoblastomycosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D021903:DNA, Ribosomal Spacer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D021903:DNA, Ribosomal Spacer