Chromoblastomycosis is a chronic granulomatous disease caused by several species of dematiaceous fungi that invade the skin and subcutaneous tissues. It is more common in tropical and subtropical regions, and in China, it is frequently seen in Shandong, Henan, and Guangdong provinces. Common pathogenic fungi include Cladosporium carrionii, Fonsecaea pedrosoi, and Phialophora verrucosa. The disease often develops after trauma, with skin lesions predominantly occurring on exposed areas. The condition is stubborn and protracted, potentially leading to limb disability.

bubble_chart Diagnosis

1. It is more common among farmers, and patients often have a history of trauma; 2. It frequently occurs on exposed areas such as the limbs; 3. The lesion is unilateral, presenting as nodules or patches with a dirty brown color, surrounded by a purplish-red infiltrative zone. Later, the patches ulcerate, revealing granular granulation tissue. The disease progresses slowly. 4. Symptoms are mild, but it may eventually lead to elephant hide-like swelling. In rare cases, it can disseminate to the entire skin or even cause brain abscesses and meningitis.

1. More common in farmers, often with a history of trauma; 2. Skin lesions predominantly occur on exposed areas; 3. Typical skin lesion manifestations; 4. Direct microscopy reveals clusters of brown, thick-walled spores or septate hyphae, with positive culture for chromogenic fungi; 5. Histopathology of skin lesions (PAS staining) shows brown, thick-walled spores within epidermal microabscesses and multinucleated giant cells. [Treatment Principles] 1. Systemic antifungal medications; 2. Topical antifungal agents; 3. Local surgical excision, laser therapy, cryotherapy, thermotherapy, or physical therapy.

1. Cure: Skin lesions disappear, and fungal direct microscopy and culture are negative once a month for three consecutive times; 2. Improvement: Skin lesions partially subside, and fungal examination is negative or positive; 3. No cure: Skin lesions show no improvement, and fungal examination is positive.