Combination Treatment of Itraconazole and Terbinafine for Chromoblastomycosis Caused by Fonsecaea pedrosoi
Keywords:
Chromoblastomycosis, Fonsecaea pedrosoi, combination treatment, itraconazole, terbinafineAbstract
Chromoblastomycosis is a chronic subcutaneous fungal infection mainly caused by Fonsecaea pedrosoi. This report describes a 42-year-old man with a verrucous plaque on the right ankle, initially presenting as small papules ten years ago, progressively enlarging. The patient, an oil palm worker, had a history of recurrent trauma and inadequate antifungal treatment. Diagnosis was confirmed by KOH, histopathology, and culture showing Fonsecaea pedrosoi. Combination therapy with itraconazole 100 mg twice daily and terbinafine 250 mg once daily for six months led to complete clinical and mycological cure. This case emphasizes the role of combined antifungal therapy in neglected chromoblastomycosis and the importance of early diagnosis and adherence to treatment.References
Brito AC, Bittencourt MJS. Chromoblastomycosis: an etiological, epidemiological, clinical, diagnostic, and treatment update. An Bras Dermatol. 2018; 93(4):495-506.
Doi: 10.1590/abd1806-4841.20187321.
Abraham TS, Manjunatha P. Case report - a case of chromoblastomycosis effectively treated with oral terbinafine. Int J Health Sci Res. 2022;12(6):270–3.
Gupta AK, Taborday PR, Sanzovoy AD. Alternate week and combination itraconazole and terbinafine therapy for chromoblastomycosis caused by Fon-secaea pedrosoi in Brazil. Med Mycol. 2002;40(5): 529-34. Doi: 10.1080/mmy.40.5.529.534.
Rositawati A, Suyoso S. Chromomycosis treatment with combination of itraconazole and terbinafine. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2017; 29(2):168–74.
Hay RJ. Deep Fungal Infections. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick’s dermatology. 9th edn. New York: McGraw-Hill Education; 2019. p. 2965–87.
Dharmawan N, Fiqri A. Chromoblastomycosis tre-atment with combination therapy of itraconazole (pulse dose) and cryotherapy. Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan. 2021; 15(2):219–25.
Errichetti E, Ankad B, Chatterjee M, Pinton PC, Maione V, Chauhan P. Mycoses. In: Errichetti E, Lallas A, editors. Dermoscopy in General Derma-tology for Skin of Colour. London: CRC Press; 2022. p. 133–5.
Patterson JW, Hosler GA, Prenshaw KL. Mycoses and algal infections. In: Weedon’s skin pathology. 5th edn. China: Elsevier; 2021. p. 721–56.
Acosta-Zamora A, Jaikel-Víquez D. Combined acti-vity of itraconazole and terbinafine on clinical iso-lates of Neoscytalidium dimidiatum. Acta Med Co-starric. 2021;63(1):43–50.
Ghannoum M, Salem I, Christensen L. Antifungals. In: Kang S, Amagai M, Bruckner AL, Enk AH, Mar-golis DJ, McMichael AJ, et al., editors. Fitzpatrick’s dermatology. 9th edn. New York: McGraw-Hill Education; 2019. p. 3436–50
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