title: A Clinico-Mycological Study on Suspected Cases of Chromoblastomycosis: Challenges in Diagnosis and Management.
abstract: BACKGROUND
  Verrucous plaques mimicking chromoblastomycosis are frequently seen in dermatology outpatient departments (OPD). However, no scientific evaluation has been carried out till date from eastern India. So this present endeavour is aimed at a thorough study of those cases to readdress the challenges in diagnosis and management in chromoblastomycosis from this part of the country.
  
  
  OBJECTIVE
  The study is to observe the incidence of proved chromoblastomycosis cases from clinically mimicking conditions and to note therapeutic prospects by use of different antifungal agents.
  
  
  METHODS
  Twenty clinically suspected cases attending dermatology OPD were included in this study. Relevant histories were taken. Apart from routine hematological and biochemical investigations, scrapings from lesions were examined by direct microscopy with KOH wet mount, calcoflour white mount and fungal culture. Histopatholgical examination was also done. Any fungal growth was identified by growth characteristics and morphological features.
  
  
  RESULTS
  Sclerotic bodies were detected in five samples. Of them three were found to be culture positive. Two growths were identified as Fonsecaea pedrosoi and one as Cladosporium carrionii. Rest 12 cases were diagnosed as either lupus vulgaris (3 cases; 15%), atypical mycobacterial infections (3 cases, 15%), Hypertrophic lichen planus (2, 10%), Hypertrophic DLE plaque (2; 10%), Wart (1, 5%) or fixed cutaneous sporothricosis (1, 5%), zygomycosis (1, 5%). Three cases (15%) were lost in follow up. Cases of chromoblastomycosis were managed with prolonged use of antifungal alone or in combination with saturated solution of potassium iodide and/or debridement. They were followed up for at least six months post treatment.
  
  
  CONCLUSIONS
  A database comprising diagnostic clues and effective therapeutic intervention have been proposed for these rare subcutaneous mycoses.
authors.affiliation: Assistant Professor, Department of Microbiology, IPGME&R , Kolkata, India .
authors.forename: Hirak Jyoti
authors.initials: HJ
authors.lastname: Raj
authors.affiliation: Post Graduate Trainee, Department of Dermatology, IPGME&R , Kolkata, India .
authors.forename: Banashree
authors.initials: B
authors.lastname: Majumdar
authors.affiliation: Post Graduate Trainee, Department of Dermatology, IPGME&R , Kolkata, India .
authors.forename: Atul
authors.initials: A
authors.lastname: Jain
authors.affiliation: Professor and Head, Department of Microbiology, IPGME&R , Kolkata, India .
authors.forename: Prasanta Kumar
authors.initials: PK
authors.lastname: Maiti
authors.affiliation: Professor and Head, Department of Dermatology, IPGME&R , Kolkata, India .
authors.forename: Gobinda
authors.initials: G
authors.lastname: Chatterjee
keywords: Dematecious fungi; Sclerotic bodies; Subcutaeneous mycoses
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