Chromomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue that is caused by fungi or “black yeasts” (mycosis) that produce a characteristic pigment (dematiaceous). It predominates in tropical, subtropical and temperate climates. It usually affects adults between 20 and 60 years old or older.
Causes of chromomycosis
Dematiaceous fungi that multiply by direct division
Chromomycosis is caused by saprophytic fungi, which obtain their nutrition from waste, and are found in the soil, vegetables or plants, among other places. The main fungi that cause this disease are the ‘dimorphous Hyphomycetes’, dematiaceous, which in their parasitic phase have round or oval structures that measure 4 to 8 microns in length. They are multiplied by direct division. The fungus enters the skin through a small wound or scrape.
The most common fungus that causes chromomycosis is ‘Fonseacae pedrosoi’ but it can also appear due to ‘Fonsecae Compacta’, ‘Phialosophora verrucosa’, ‘Cladophialophora carrionii’ or ‘Rhinocladiella aquaspersa’.
Chromomycoses are classified as:
– Nodular or tumor chromomycosis.
– Verrucous chromomycosis.
– Elephantia chromomycosis.
– Plaque chromomycosis.
– Scarring chromomycosis.
Symptoms of chromomycosis
They appear around 40 days after inoculation
The symptoms of chromomycosis appear around 40 days after the fungus is inoculated into the body and are usually:
– Scaly erythema on the skin that becomes warty and evolves into an abscess with granulomatous tissue with an irregular surface and visible microbleeds as blackheads.
– Violet nodules.
– Warts.
– Atrophy.
– Intense itching.
– Intense sensitivity to pressure.
The lesions are usually located in the lower extremities but can appear in other areas. Chronic ulcers can lead to squamous cell carcinoma.
Diagnosis of chromomycosis
Physical examination, culture, and blood tests
To diagnose chromomycosis, the doctor will perform a visual examination, remove tissue samples to examine under the microscope, and order a culture of a sample to identify the causative fungus. You may also order blood tests to look for antibodies and imaging tests such as a chest x-ray.
The differential diagnosis must exclude pathologies such as tuberculosis, sporotrichosis, leishmaniasis or chronic dermatitis, among others.
Treatment and medication of chromomycosis
Antifungals and cryosurgery
There is no specific treatment against chromomycosis. The guideline is the prescription of antifungal drugs and also the application of cryosurgery with liquid nitrogen.
Prevention of chromomycosis
Protect the skin with appropriate footwear and clothing
Prevention measures against chromomycosis involve protecting the skin through which it can be inoculated by wearing appropriate clothing that covers and covers and avoiding open shoes when walking in the countryside, flip-flops, etc. If there are scratches or wounds, they must be well protected.
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