Chromoblastomycosis (Chromomycosis)

Sitti Aisyah Rieskiu Ernawati Shinta Pramita D A.Muh. Hadi Kusuma Nadia Azpia Tuasikal C11107081 C11107083 C11107080 110207046 110207036

Case Report

Name Sex Age Work Marriage status

: MNN : Male : 67 years old :: Married

Anamnesis

Primary Kompliant : Edema in left foot Since 12 motnhs ago Pain in plantar foot Itchiness Bump filled with liquid on left foot, initially looked little by the time increasingly more larger than before.

Present status

Vital sign : BP : 140/90 mmHg H : 80 x/min B : 22 x/m T : 370C General condition : mild Hygiene : bad Consciousness : Compos Mentis

Dermatovenorology

Efflorescence Location Itchiness Pain

: Nodule, vesicle, erythema, edema : Left foot

Laboratory result

WBC RBC HGB HCT PLT SGOT SGPT Ureum Creatinin P<1,1)

: x 10 / l : x 106 / l : g/dL :% : x 10 / l : U/l : U/l : mg/dl : mg/dl

(N : 4,00-10,00) (N : 4,00-6,00) (N :12,00-16,00) (N : 37,0-48,0) (N : 150-400) (N : <48) (N : <41) (N : 10-50) (N : L<1,3,

Lab

result -

Further Examination

Biopsy

Resume

A 67 years old man came to hospital with a complain edema in left foot and pain in plantar foot and itchiness in left foot since 12 months ago. Patient had been contact or work in the garden. History of disease: Patient post stroke 7 years ago, Patient had hypertension, cholesterol and uric acid always high 7 years ago, Family history (-) Internal status in .. range. Dermatology status: location at left foot, edema, erythema, vesicle, and nodule. Vital status in abnormal BP range.

Diagnosis

Chromoblastomycosis

Treatment

Compress Potassium Permanganate liquid (PK) 1:10.000 Plainning of biopsy (waiting for laboratory result )

Chromoblastomycosis (Chromomycosis)

Defenition

A chronic fungal infection of the skin and subcutaneous tissues caused by pigmented fungi, which produce thick- walled single or multi celled clusters (sclerotic or muriform bodies) in tissue, and which are characterized by the production of slow growing exophytic lesions, usually on the feet and legs.

Etiology

Chromoblastomycosis is caused by several fungi, the most common of which are Phialophora verrucosa, Fonsecaea pedrosoi, F. compacta and Cladophialophora carrionii (recent synonym Cladosporium carrionii). Other rare causes include Rhinocladiella aquaspersa. The nomenclature of these fungi has been reviewed by McGinnis. The causal fungi have been isolated from wood and soil, and the infection usually results from trauma, such as a puncture from a splinter of wood. The condition is usually found in rural communities.

Clinical Features

The lesions are usually found on exposed sites, particularly the feet, legs, arms, face and neck. A warty papule slowly enlarges to form a hypertrophic plaque. Painless secondary infection causes itching and pain. Satellite lesions are produced by scratching, and There may be lymphatic spread to adjacent areas. Squamous carcinomas may develop in chronic lesions.

Differential Diagnose
Phialophora

verrucosa Fonsecaea pedrosoi Cladophialophora carrionii

Treatment
Antifungal

chemotherapy Traconazole (100200 mg daily) or Terbinafine (250 mg daily) Cryotherapy or the local application of heat Surgery is contentious; in larger plaques there is a risk in pursuing this approach as satellite lesions may develop around the excision site.