Chromoblastomycosis presenting as a phagedenic ulcer on the face

Abstract

Chromoblastomycosis is a chronic fungal infection which presents as a small ulcer, plaques, papulonodular lesion to cauliflower-like warty masses and cicatricial forms. The disease is relatively uncommon, with only a few published case report. A 35-year-old female presented with phagedenic ulcer on the face since 15 years. Examination identified a plaque with central perforation on the right side of the face with crusting and oozing and a scar at the periphery with visible underlying turbinates. A biopsy was done and sent for histopathologic examination and culture. Treatment was started with oral fluconazole, 150 mg daily orally, suspecting subcutaneous fungal infection. Biopsy revealed branched, septate, brown-colored dematiaceous hypae in the dermis indicating chromoblastomycosis. Fungal culture revealed Fonsecaea pedrosoi. Patient responded well to treatment, and still she is on treatment. We believe that this is the first case report of chromoblastomycosis presenting as phagedenic ulcer.