Chromoblastomycosis

Question 1

affects

Answer 1

one of lower extremities.

direct inoculation of the skin.

Question 2

lesion

Answer 2

Small, pink, scaly papule or warty growth on some part of the foot or lower leg. then sloy spread theougg direct extension and satellite lesions. w time dev a bverrucous pr nodular border and central atrophy and scarring. small lesions resemble common warts!
regional lymphadenitis result from secondary bacterial infection. and lymphangitic pattern of infection.

4:1 male predominance. farmers- 75% of pxs w chromobasto.

slowly progressive. ave tome bet appearance of lesions and dx is almost 15 yrs.

Question 3

etio

Answer 3

fonsecaea pedrosoi- most common wnd cause accounts ror 90% or more of cases in south america.

Question 4

Histopath

Answer 4

paeudoepitheliomatous hyperplasia
intraepidermal abscess
dermal granulomatous reaction
pigmented fungal sclerotic bodies.

sclerotic bodies “ medlar bodies”, copper pennies.
medlar bodies easily identified- prod melanin.

ziehl neelsen, wade fite stains- identify pathogenic organisms.

Question 5

1st recognized in

Answer 5

brazil.

trauma from wood products and soil exposure

Question 6

tx

Answer 6

30% cured
60% improved
10% fail tx.

recudescence - more than 40% of pxs.
smaller lesions- best tx w surgical excision or cryotx.

extensive, chronic, burrowing- itraconazole 200-400mg/day for 6-12 mos until there is a response.
Terbinafine 500-1000 mg/day alone or in combination w itraconazole 200-400mg/day.

resistant- comb of amphotericin b and itraconazole.