Cutaneous Chromomycosis Research Articles

A Case of Systemic Lupus Erythematosus Complicated by Cutaneous Chromomycosis and Cryptococcosis

A Case of Systemic Lupus Erythematosus Complicated by Cutaneous Chromomycosis and Cryptococcosis

Spores and mycelia in cutaneous chromomycosis

In 2 cases of cutaneous chromomycosis, potassium hydroxide preparations of lesional crust/scale easily revealed characteristic Medlar bodies. However, in both instances mycelia were also demonstrated. This contradicts the prevailing belief that concomitant spores and mycelia are found only in cerebral chromomycosis. (J Am Acad Dermatol 1998;39:850-2.)

Persistent viability of the Medlar body.

The Medlar body represents an adaptive tissue form of the fungi known to cause cutaneous chromomycosis. This study was designed to determine the in vitro viability of Medlar bodies that are found in profusion within lesional epidermis. Epidermal scrapings of three indigenous cases from Texas of chromomycosis due to Fonsecaea pedrosoi were collected and periodically cultured to determine the duration of fungal viability. The causative organism could be recovered 11, 15, and 18 months, respectively, after epidermal scrapings were obtained from the three patients. This simple but important experiment indicates that Medlar bodies are quite hardy. Thus, clinical lesions may appear after long incubation periods subsequent to traumatic implantation of etiologic fungi. The robust adaptability of the tissue form may also account for the difficulty in achieving a "cure" in cases of chromomycosis.

Cutaneous Chromomycosis in Renal Transplant Recipients: Successful Management in Two Cases

• Cutaneous chromomycosis occurred in two renal transplant recipients from the south central United States. Both patients have been managed successfully with surgical excision of isolated lesions, and the condition of one of these has been improved but not cured with low-dose ketoconazole therapy. Even in the immunocompromised host, localized cutaneous chromomycosis may not require more aggressive systemic antifungal chemotherapy. ( Arch Intern Med 1985;145:1036-1037)

Cutaneous Chromomycosis in Renal Transplant Recipients

Cutaneous chromomycosis occurred in two renal transplant recipients from the south central United States. Both patients have been managed successfully with surgical excision of isolated lesions, and the condition of one of these has been improved but not cured with low-dose ketoconazole therapy. Even in the immunocompromised host, localized cutaneous chromomycosis may not require more aggressive systemic antifungal chemotherapy.

Cutaneous chromomycosis in renal transplant recipients. Successful management in two cases

Cutaneous chromomycosis occurred in two renal transplant recipients from the south central United States. Both patients have been managed successfully with surgical excision of isolated lesions, and the condition of one of these has been improved but not cured with low-dose ketoconazole therapy. Even in the immunocompromised host, localized cutaneous chromomycosis may not require more aggressive systemic antifungal chemotherapy.

Transepithelial Elimination in Papular Mucinosis

To the Editor.— Transepithelial elimination (TE) is a recognized mechanism in the formation of keratotic papules and nodules in a variety of skin diseases. Dermatoses displaying this phenomenon include calcinosis cutis, osteoma perforans, granuloma annulare, elastosis perforans serpiginosa, reactive perforating collagenosis, and perforating folliculitis, as initially reported by Mehregan. 1 This list has been expanded to include Kyrle's disease, 2,3 necrobiosis lipoidica, 4 pseudoxanthoma elasticum, 5 chondrodermatitis nodularis chronica helicis, 6 cutaneous chromomycosis, 7 eruptive vellus hair cysts, 8 and malignant melanoma. 9 Transepithelial elimination can be suspected clinically when indolent keratotic papules fail to respond to treatment that is usually successful in diseases displaying a localized epidermal hypertrophy. The histologic pattern of TE is essentially the same within this heterogenous group and consists of the following: (1) epidermal hyperplasia, (2) a central crater with a keratinous plug, (3) direct communication of the crater to histochemically altered material in the

Ultrastructural features of chromoblastomycosis.

Ultrastructural features of the Medlar body, the tissue form of cutaneous chromomycosis, are reported. Striking variability in such features reflects the interaction between fungi and host defense mechanisms.

Topical Heat Therapy for Cutaneous Chromomycosis

An aged man with a large scaly plaque over the left buttock was successfully treated by local heat therapy using an electric bed-warmer with a surface temperature of 46 degrees C. Clinically, the lesion involuted completely after two months of treatment. This was concomitantly confirmed by histopathological and mycological studies of biopsy specimens obtained from the lesion at an interval of several weeks. The isolated fungus strain of Fonsecaea pedrosol could grow at 37 degrees C on Sabouraud's dextrose agar, but was totally eradicated 24 hours after the culture was incubated at 46 degrees C. We consider that local heat therapy carried out under strict supervision is a quite effective treatment for chromomycosis. Moreover, it can be performed safely and without much discomfort to patients, and can yield satisfactory results in a relatively short time.

Topical heat therapy for cutaneous chromomycosis

Topical heat therapy for cutaneous chromomycosis

Transepithelial Elimination of Cutaneous Chromomycosis

We have recently reviewed the histologic findings in two cases of cutaneous chromomycosis. Multiple histologic sections of surgical biopsy material disclosed changes that represent the phenomenon of transepithelial elimination (TEE). We suggest that TEE represents the histogenesis of the epithelial changes in chromomycosis and possibly other infectious granulomas. Materials and Methods Excisional biopsy specimens from active lesions of two patients with cutaneous chromomycosis were fixed in formaldehyde solution and stained with hematoxylin-eosin. A total of 460 sections were evaluated for the presence of fungal organisms and their relation to various stages of epidermal proliferation. Histologic Evaluation and Interpretation The epidermis showed parakeratosis and irregular acanthosis, with projections of the epidermal and follicular epithelium downward into the corium (Figure, top left). The dermis contained a dense inflammatory infiltrate composed predominantly of mononuclear cells (histiocytes, lymphocytes, a few plasma cells) and some foreign body giant cells intermingled with polymorphonuclear leukocytes. The organisms

Transepithelial elimination of cutaneous chromomycosis

We have recently reviewed the histologic findings in two cases of cutaneous chromomycosis. Multiple histologic sections of surgical biopsy material disclosed changes that represent the phenomenon of transepithelial elimination (TEE). We suggest that TEE represents the histogenesis of the epithelial changes in chromomycosis and possibly other infectious granulomas. <h3>Materials and Methods</h3> Excisional biopsy specimens from active lesions of two patients with cutaneous chromomycosis were fixed in formaldehyde solution and stained with hematoxylin-eosin. A total of 460 sections were evaluated for the presence of fungal organisms and their relation to various stages of epidermal proliferation. <h3>Histologic Evaluation and Interpretation</h3> The epidermis showed parakeratosis and irregular acanthosis, with projections of the epidermal and follicular epithelium downward into the corium (Figure, top left). The dermis contained a dense inflammatory infiltrate composed predominantly of mononuclear cells (histiocytes, lymphocytes, a few plasma cells) and some foreign body giant cells intermingled with polymorphonuclear leukocytes. The organisms