Abstract
Chromoblastomycosis is one of the most frequent chronic infections caused by melanized fungi. In order to evaluate the clinical characteristics of chromoblastomycosis in Mainland China, we performed an evidence-based review of published literature. PubMed and Chinese-language database of CNKI, VIP and Wanfang data during January 1990–August 2011 were searched. Epidemiology, clinical features, laboratory findings, therapy and prognosis were analyzed. Cladophialophora carrionii was the most common causative agent in the north of the Mainland China, and Fonsecaea monophora and F. pedrosoi were the most common agents in the southern part of the Mainland China. Infection commonly initiated after the etiologic agents gain entrance through puncture wounds and more common involved extremities of the males. Skin lesions were found in different sites, like the extremities, buttocks, trunk and face, and presented diversity morphology. There were about seven different clinical types found in Mainland China: plaque type, tumoral type, cicatricial type, verrucous type, pseudo-vacuole type, eczymatous type and mixed type of lesions. The success of treatment for chromoblastomycosis was related to the causative agent, the clinical form and severity of the lesions. Most of the patients could be treated successfully with the physical treatment, chemotherapy and/or combination therapy. The itraconazole, terbinafine or a combination of both were commonly medication for these mycosis patients. Physical methods were usually indicated to support chemotherapy with some severe forms and long-lasting cases. Photodynamic therapy has been extended from the oncological field to that of antimicrobial chemotherapy in these years. We applied it on some recalcitrant cases of chromoblastomycosis and found its good clinical response, and hopeful it could be a promising therapy in near future.
Similar content being viewed by others
References
Yu RY, Gao L. Chromoblastomycosis successfully treated with fluconazole. Int J Dermatol. 1994;33:716–719.
Yu R. Successful treatment of chromoblastomycosis with itraconazole. Mycoses. 1995;38:79–83.
Xibao Z, Changxing L, Quan L, Yuqing H. Treatment of chromoblastomycosis with terbinafine: a report of four cases. J Dermatol Treat. 2005;16:121–124.
Yang Y, Hu Y, Zhang J, Li X, Lu C, Liang Y, et al. A refractory case of chromoblastomycosis due to Fonsecaea monophora with improvement by photodynamic therapy. Med Mycol 2012.
Xi L, Lu C, Sun J, Li X, Liu H, Zhang J, et al. Chromoblastomycosis caused by a meristematic mutant of Fonsecaea monophora. Med Mycol. 2009;47:77–80.
Zhang JM, Xi LY, Zhang H, Xie Z, Sun JF, Li XQ, et al. Synergistic effects of terbinafine and itraconazole on clinical isolates of Fonsecaea monophora. Eur J Dermatol. 2009;19:451–455.
Zhang J, Xi L, Lu C, Li X, Xie T, Zhang H, et al. Successful treatment for chromoblastomycosis caused by Fonsecaea monophora: a report of three cases in Guangdong. China Mycoses. 2009;52:176–181.
Queiroz-Telles F, Esterre P, Perez-Blanco M, Vitale RG, Salgado CG, Bonifaz A. Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment. Med Mycol. 2009;47:3–15.
Shankar J, Restrepo A, Clemons KV, Stevens DA. Hormones and the Resistance of Women to Paracoccidioidomycosis. Clin Microbiol Rev. 2011;24:296–313.
Castro RM, Castro LGM. On the priority of description of chromomycosis. Mykosen. 1987;30:397–403.
Rudolph M. über die brasilianische ‘Figueira’ (Vorläufige Mitteilung). Archiev Schiffs und Tropen-Hyg. 1914;18:498–499.
De Hoog GS, Attili-Angelis D, Vicente VA, Van Den Ende AH, Queiroz-Telles F. Molecular ecology and pathogenic potential of Fonsecaea species. Med Mycol. 2004;42:405–416.
Xi L, Sun J, Lu C, Liu H, Xie Z, Fukushima K, et al. Molecular diversity of Fonsecaea (Chaetothyriales) causing chromoblastomycosis in southern China. Med Mycol. 2009;47:27–33.
Andrade TS, Castro LGM, Nunes RS, Gimenes VMF, Cury AE. Susceptibility of sequential Fonsecaea pedrosoi isolates from chromoblastomycosis patients to antifungal agents. Mycoses. 2004;47:216–221.
Klein A, Babilas P, Karrer S, Landthaler M, Szeimies R M. (2008) Photodynamic therapy in dermatology—an update 2008. J Dtsch Dermatol Ges 6:839–845, 839–846.
Lyon JP, Moreira LM, de Resende MA. Photodynamic Antifungal Therapy Against Chromoblastomycosis. Mycopathologia. 2011;172:293–297.
Zhang RY, Cheng ZM. A case of Chromoblastomycosis. Chinese Journal of Diagnostic Pathology. 1995:241 (Chinese).
Nan GR, Wang GS, Si RL, Zhang GZ. A case of chromoblastomycosis cured with itraconazole. Chinese Journal of Dermatology. 1997:65 (Chinese).
Yan H. A case of Cutaneous Chromoblastomycosis. Chin J Clin Exp Pathol. 1997:76 (Chinese).
Li CY, Yan QD. Five case of chromoblastomycosis cured with itraconazole. J Clin Dermatol. 2000:352–353 (Chinese).
Li JL, Wang HW, Tang S. A case of chromoblastomycosis caused by Fonsecaea Compact. Chin J Dermatol. 2000:66 (Chinese).
Zhang XB, Huang JM. Misdiagnosis in one case with chromoblastomycosis. Chin J Dermatovenereol. 2000:63–64 (Chinese).
Yu CP, Wu M, Zhang FR. Treatment of chromoblastomycosis with itraconazole and local thermotherapy. Chin J Dermatovenereol. 2002:28–29 (Chinese).
Li CY, Shu Y, Guo SL. Clinical study in treatment of chromoblastomycosis with terbinafine. Chin J Dermatol. 2002:82 (Chinese).
Huang JM, Chen YF, Pan HQ. A case of chromoblastomycosis caused by Fonsecaea Pedrosoi. Southern China J Dermato-Venereol. 2002:40–41 (Chinese).
Li L, Xu HS, Wang JJ. A case of chromoblastomycosis with lymphatic spread. J Clin Dermatol. 2002:450–451 (Chinese).
Li M, Wu XF, Shen YN. Chromomycosis successful treated by surgical excision combined with terbenafine: report of a case. J Clin Dermatol. 2002:509–510 (Chinese).
Zhang QQ, Wei W, Wang JJ. A case of cutaneous chromoblastomycosis caused by Fonsecaea Pedrosoi. Chin J Dermatovenereol. 2002:50–51 (Chinese).
Zong WK, Zeng XS, Pan XF. Chromomycosis successful treated by surgical excision combined with Itraconazole: report of a case. Chin J Lepr Skin Dis. 2002:69–70 (Chinese).
Zhang YJ, Zhang GM, Zheng LX. Chromoblastomycosis caused by Fonsecaea Pedrosoi: the first case report in shenzhen and analysis. Chin J Dermatovenereol. 2003:50–52 (Chinese).
Gong YQ, Lu YW, Zhu HL. A case of Cutaneous Chromoblastomycosis Caused by Fonsecaea Pedrosoi. Southern Chin J Dermato-Venereol. 2008:299–300 (Chinese).
Wang J, Wu WX. A case of central nervous system invasion of chromoblastomycosis. J Hebei Med Univ. 1996:56 (Chinese).
Hui HY, Wang XL, Feng YG. A case of chromoblastomycosis Caused by Fonsecaea Pedrosoi. J Clin Dermatol. 2004:754 (Chinese).
Lu GL, Yao FL, Zhan QX. A case of Cutaneous Chromoblastomycosis. Chin J Dermatovenerol Integr Tradit and West Med. 2005:47 (Chinese).
Hui HY, Liu P, Wang XL. A case of pemphigus erythematosus patient with chromoblastomycosis. Chin J Dermatovenereol. 2005:301–302 (Chinese).
Qian LJ, Li L, Zhang QQ. A case of cutaneous chromoblastomycosis caused by Phialophora verrucosa. Chin J Dermatovenereol. 2005:556–557 (Chinese).
Pei ZH. A case of chromoblastomycosis cured by liquid nitrogen cryotherapy. Chin J Lepr Skin Dis. 2005:482–483 (Chinese).
Zhang TZ, Hu ZM, Kong Q Y. Treatment of chromoblastomycosis with terbinafine and local thermotherapy: a case report. J Clin Dermatol. 2006:403–404 (Chinese).
Xu XR, Li XQ, Xi LY. Chromomycosis caused by Fonsecaea pedrosoi. J Clin Dermatol. 2006:696–697 (Chinese).
Liu XW, Xu LC, Wang ZB. A case of cutaneous chromoblastomycosis. J Dermatol Venereol. 2006:55–56 (Chinese).
Liu GY, Jiang LY, Jin H. A case of Chromoblastomycosis. Chin J Lepr Skin Diseas. 2007:898–900 (Chinese).
Cha JD, Liu DX, Li SQ. A case of chromoblastomycosis cured combined with potassium iodide and itraconazole. Herald Med. 2007:270 (Chinese).
Liao J, Wu CH, Wu ZH. A case of chromoblastomycosis cased by Fonsecaea Pedrosoi misdiagnosed as tuberculosis verrucosa cutis. Southern Chin J Dermato-Venereol. 2008:38–40 (Chinese).
Jin XJ, Wang AP, Chen W. A case of chromoblastomycosis cured with itraconazole. Chin J Mycol. 2008:76–77 (Chinese).
Lv GX, Chen XJ, Shen YN. A case of Cutaneous Chromoblastomycosis Caused by Fonsecaea monophora. Chin J Mycol. 2009:155–157 (185) (Chinese).
Ou YG, Lin Y, Li HY. A Case of Chromoblastomycosis Misdiagnosed as Tuberculosis Cutis. Chin J Dermatovenereol. 2009:601–602 (Chinese).
Lu Y, He W, Weng X. Treatment of chromoblastomycosis with itraconazole and local thermotherapy: a case report. Chin J Dermatovenereol. 2009:454–455 (Chinese).
Li GZ, Liu YH, Li JJ. A case of cutaneous chromoblastomycosis. Chin J Dermatovenereol. 2010:878–879 (Chinese).
Liu HF, Xue RZ, Huang JM. Clinical analysis of chromoblastomycosis and identification of Fonsecaea monophora. China Tropical Medicine. 2010:1062–1064 (Chinese).
Chen HH, Li WQ, Huang W. A case of chromoblastomycosis with lymphatic spread. J Diagnos and Therap Dermato-venereol. 2010:373–374 (Chinese).
Jiang Q, Jin Y, Li ZH. A case of chromoblastomycosis caused by Fonsecaea Pedrosoi. Chin J Dermatovenereol. 2010:65–66 (Chinese).
Zhao ZT, Lu QY, Gao N. Chromoblastomycosis caused by Fonsecaea monophora in North China: first case report and. Chin J Mycol. 2010:193–195 (Chinese).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lu, S., Lu, C., Zhang, J. et al. Chromoblastomycosis in Mainland China: A Systematic Review on Clinical Characteristics. Mycopathologia 175, 489–495 (2013). https://doi.org/10.1007/s11046-012-9586-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11046-012-9586-z