Chromomycosis is a chronic localized invasive fungal infection of skin and subcutaneous tissues characterized by verrucous plaques on the leg or foot, caused by dematiaceous (dark-colored) fungi.
Causes of Chromomycosis
- Traumatic inoculation of saprophytic soil fungi
- Phialophora fungi
- Fonsecaea fungi
- Cladosporium fungi
Diagnosis
Clinical suspicion confirmed by visualization of Medlar bodies on smear of pus or lesional biopsy specimen and/or isolation of organism on culture.
Treatment
Adjunctive Therapy Application of heat may be helpful in that lesions arise at cooler acral sites.
Surgery Smaller lesions can be cured by surgical excision.
Systemic Antifungal Therapy Amphotericin B: usually is not effective at usual dosing.
Oral Antifungal Agents Treatment is usually continued for at least 1 year. The response is highly variable.
Terbinafine, 250 mg/d
Itraconazole, 200 to 600 mg/d
Ketoconazole, 400 to 800 mg/d
References