Chromomycosis: Case Reports of Exuberant Forms Including Carcinomatous Degeneration

Abstract

Chromomycosis, or chromomycosis, is a chronic, progressive cutaneous and subcutaneous mycosis caused by several species of pheoid or dermaticeous (darkly pigmented) fungi. It mainly affects male patients, in the age group between 30 and 60 years and is more common on rural areas, being associated to traumatic events, which may explain the high frequency of involvement of the lower limbs and exposed areas. Its lesion starts as a small, nonpruriginous, erythematous papule or macula and slowly spreads to the surrounding skin. Commonly, takes 5 to 15 years or more from the onset to diagnosis the disease. The disease progress and evolve to variable morphology types, chronic lesions and complications usually lead to definitive disability, especially due to treatment limitations. We present three cases of exuberant and disfiguring chromomycosis, including a case were the lesions suffered carcinomatous degeneration. All patients complained about the drug price and one of them abandoned the treatment and medical follow up. All patients were from rural area, one of them complained about the absence of medication and reported financial difficulties for transportation. In conclusion, physicians must be aware of chromomycosis as a possible diagnosis when considering a chronic skin condition. Although not common, prevention strategies and alternative therapies should be investigated to improve chromomycosis management, especially in undeveloped regions. The distance and difficulties to accesses health services may delay the diagnosis and prejudice the treatment, given that small and initial lesions have better prognosis, impairing the improvement in patients’ quality of live and the prevention of severe complications and morbidities.