Spores and mycelia in cutaneous chromomycosis,☆☆,

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Abstract

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.)

Section snippets

Case 1

A 62-year-old man first noted an occasionally pruritic “wartlike” papule on his left forearm 10 years previously. The lesion gradually increased in size until it covered the majority of his forearm (Fig 1).

. Arm lesions in case 1.

Social history revealed that the patient was employed outdoors and was an avid gardener. Past medical history, including risk factors for immunosuppression, was entirely negative. Several scrapings taken from the verrucous, scaly border of the skin lesion revealed

DISCUSSION

Chromomycosis (or chromoblastomycosis) is a slowly progressive cutaneous mycosis caused by various dematiaceous (pigmented) fungi. The primary lesion is thought to develop as a result of percutaneous traumatic inoculation.6 Rarely, chromomycosis may involve the central nervous system, generally without concomitant skin involvement.7, 8 This cerebral variant is usually due to Cladosporium trichoides . Unlike phaeohyphomycosis (infection by other dematiaceous fungi), chromomycosis reportedly does

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    Citation Excerpt :

    Fungal cells with their characteristic micromorphology – round, dark-brown, thick-walled, 4-12 microns in diameter and with multiplanar reproduction, called muriform (sclerotic) bodies – are found in intraepidermal microabscesses in multinucleated Langhans and/or foreign body-type cells, in suppurative or tuberculoid granulomas, easily identified by hematoxylin-eosin staining (Figure 11C). Dimorphism may be observed, and it is possible to identify hyphae and muriform bodies in material from skin lesions.94 Pires et al., in a study of 65 patients that underwent histopathological examination with HE staining, found two main types of granulomatous tissue reaction: suppurative granuloma with abundant fungal cells, mostly from verrucous lesions, and tuberculoid granuloma, with few parasites, from plaque and atrophic lesions.95

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This article is made possible through an educational grant from Ortho Dermatological.

☆☆

Reprint requests: Sylvia Hsu, MD, Department of Dermatology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030

0190-9622/98/$5.00 + 0  16/4/91718

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