Chromoblastomycosis Clinical Management and Pathogenicity

Chromoblastomycosis is a chronic, granulomatous mycosis of the skin and subcutaneous tissues caused by traumatic inoculation of dematiaceous fungi. It predominantly affects populations in tropical and subtropical regions, especially agricultural workers, and often leads to verrucous plaques, nodules and scarring. The pathogenicity of the principal agents—Fonsecaea, Cladophialophora and Phialophora species—stems from their melanin-enriched cell walls, which confer resistance to oxidative killing and facilitate evasion of innate immune recognition. Failure of coordinated pattern recognition receptor signalling contributes to persistent infection and chronic inflammation. Clinical management remains challenging: long courses of systemic antifungal agents such as itraconazole or terbinafine are frequently combined with physical modalities (surgical excision, cryotherapy or photodynamic therapy) and, more recently, immunomodulatory approaches (for example topical imiquimod). Advances in molecular diagnostics and strategic global planning aim to improve early detection, guide treatment selection and reduce the substantial morbidity, stigma and disability associated with this neglected tropical disease.

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Chromoblastomycosis Clinical Management and Pathogenicity publication trend

The graph below shows the total number of articles in chromoblastomycosis clinical management and pathogenicity across all publications each year (not limited to Nature Index journals).

Technical terms

Dematiaceous fungi: A group of darkly pigmented moulds containing melanin in their cell walls, responsible for chromoblastomycosis and other phaeohyphomycoses.

Granulomatous mycosis: A chronic inflammatory response characterised by granuloma formation around persistent fungal elements in tissue.

Sclerotic bodies: Also known as muriform cells, these are thick-walled, pigmented fungal cells seen in tissue that confirm chromoblastomycosis.

PCR–RFLP: A molecular diagnostic technique combining polymerase chain reaction and restriction fragment length polymorphism to differentiate fungal species.

Immunomodulator: An agent, such as imiquimod, that modifies the host immune response to enhance clearance of infection.

References

1. A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group. PLOS Neglected Tropical Diseases (2024).
2. Identification of Chromoblastomycosis and Phaeohyphomycosis Agents through ITS-RFLP. Journal of Fungi (2024).
3. Analysis of the synergistic antifungal activity of everolimus and antifungal drugs against dematiaceous fungi. Frontiers in Cellular and Infection Microbiology (2023).
4. Melanin in Fonsecaea pedrosoi: a trap for oxidative radicals. BMC Microbiology (2010).
5. Restoration of Pattern Recognition Receptor Costimulation to Treat Chromoblastomycosis, a Chronic Fungal Infection of the Skin. Cell Host & Microbe (2011).
6. Successful management of chromoblastomycosis utilizing conventional antifungal agents and imiquimod therapy. Annals of Clinical Microbiology and Antimicrobials (2024).