title: A case of chromoblastomycosis by Fonsecaea nubica indicating a possible insect route of transmission.
abstract: A first auricular case of chromoblastomycosis due to Fonsecaea nubica is reported in a 42-year-old Chinese male. He presented a slightly verrucous, erythematous plaque on his right auricle which had gradually extended over a 10-year period, and the patient reported a history of dog flea sting before onset of the lesions. Diagnosis was based on histopathological and mycological examination of clinical samples, which revealed muriform cells. Identification of the aetiological agent was assessed by morphological characteristics and confirmed at species level by sequencing of the rDNA internal transcribed spacer (ITS). The patient showed marked clinical improvement after 3 months combination therapy with itraconazole and terbinafine. The possible mode of transmission of auricular chromoblastomycosis is discussed.
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Yingdan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Songchao
authors.initials: S
authors.lastname: Yin
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Meirong
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Rongzhang
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Han
authors.initials: H
authors.lastname: Ma
authors.affiliation: Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Shuwen
authors.initials: S
authors.lastname: Deng
authors.affiliation: Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.|CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands.|Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.|Research Center for Medical Mycology, Peking University Health Science Center, Beijing, China.
authors.forename: Gert Sybren
authors.initials: GS
authors.lastname: de Hoog
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Lai
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. luliyuan@tom.com.
authors.forename: Chun
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. fpying77@gmail.com.
authors.forename: Peiying
authors.initials: P
authors.lastname: Feng
mesh_terms: D000328:Adult; D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D001203:Ascomycota / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000648:ultrastructure; D002681:China; D002862:Chromoblastomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000635:transmission*; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D054644:Ear Auricle / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D009281:Naphthalenes / Q000627:therapeutic use; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D005423:Siphonaptera / Q000382:microbiology*; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D009281:Naphthalenes; D017964:Itraconazole; D000077291:Terbinafine
keywords: Fonsecaea nubica; auricle; chromoblastomycosis; internal transcribed spacer rDNA