Chromoblastomycosis is a chronic fungal infection that affects the skin and underlying tissues. Though not widely known, it’s a significant health concern in many tropical and subtropical regions. People who live in rural areas and work outdoors especially farmers and laborers are most at risk. The infection progresses slowly, often taking years to fully develop, which means it can go unnoticed or untreated for a long time. Unfortunately, because it is not considered a major global health threat, it remains a neglected tropical disease (Queiroz-Telles et al., 2009).
What Causes Chromoblastomycosis?
This skin infection is caused by a group of pigmented fungi (known as dematiaceous fungi) that live in the environment, especially in soil, decaying wood, and plants. The most common fungi responsible are Fonsecaea pedrosoi, Cladophialophora carrionii, and Phialophora verrucosa (Bonifaz et al., 2017). Infection happens when these fungi enter the skin through minor injuries like a thorn prick or splinter while working outdoors.
It’s important to understand that chromoblastomycosis does not spread from one person to another. It’s only contracted through direct contact with the fungi in the environment (Santos et al., 2007).
How It Appears and Progresses
Chromoblastomycosis starts as a small red or itchy bump, usually on exposed parts of the body such as the legs, feet, or arms. Over time, this bump may grow larger and develop into wart-like or cauliflower-shaped lesions. These lesions may become scaly, thickened, or crusted, and can even ooze fluid or become painful in later stages (Carvalho et al., 2010).
Because the disease progresses slowly, many people ignore the early signs or treat them as minor skin issues. However, if left untreated, the lesions can grow, making it harder to walk, move, or perform daily tasks. In some long-standing cases, the infection can cause complications like bacterial infections or, rarely, skin cancer (Bonifaz et al., 2017).
How Is It Diagnosed?
Doctors usually begin by examining the appearance of the lesion and asking about the patient’s work and exposure to soil or plants. To confirm the diagnosis, a sample of the skin is examined under a microscope. A key sign is the presence of special fungal cells known as “Medlar bodies” or “copper pennies,” which appear brown and round due to their thick walls (Bonifaz et al., 2017). Additional tests like fungal cultures or molecular tests can help identify the exact species causing the infection.
Treatment Options
Chromoblastomycosis can be difficult to treat and usually requires long-term therapy. The main treatment involves antifungal medications such as itraconazole or terbinafine, which are taken orally for several months (Queiroz-Telles et al., 2009). In some cases, treatment may also include local therapies like cryotherapy (freezing), heat application, or even surgery to remove large lesions.
While treatment can be successful, early intervention is crucial. When the disease is diagnosed early, smaller lesions respond better to treatment. Unfortunately, many people seek help only when the condition has advanced, which makes therapy longer and more complicated.
Life Impact and Challenges
Though chromoblastomycosis is not fatal, it can seriously affect a person’s quality of life. The lesions can become disfiguring and make it hard to walk or work. In rural areas where medical care may be limited, people often suffer in silence. The disease can also cause emotional distress and social isolation due to the appearance of the skin lesions (Carvalho et al., 2010).
Furthermore, because it mostly affects poor communities and is rarely talked about in public health conversations, it is considered a neglected disease. This means there is limited research, few treatment options, and not enough awareness campaigns (Santos et al., 2007).
How Can It Be Prevented?
Since the fungi that cause chromoblastomycosis live in soil and vegetation, prevention focuses on avoiding direct exposure. People working in farms, forests, or gardens should wear protective clothing such as gloves, boots, and long sleeves. Educating at-risk communities about the disease and encouraging them to seek treatment early can also help reduce its impact.
In the bigger picture, more investment in healthcare access, research, and drug development is needed. Improved awareness among healthcare workers and better diagnostic tools in rural clinics could help reduce the burden of this disease.
Chromoblastomycosis may not be a household name, but it affects thousands of people across tropical regions. Caused by environmental fungi entering through the skin, it is a slow and stubborn infection that can cause significant physical and emotional hardship. Early diagnosis and long-term antifungal treatment can help manage the condition. However, more global attention and support are needed to ensure that those suffering from this neglected disease are not left behind.
References
- Bonifaz, A., Carrasco-Gerard, E., & Saúl, A. (2017). Chromoblastomycosis: Clinical and mycologic experience of 51 cases. Mycoses, 50(1), 14–19. https://doi.org/10.1111/j.1439-0507.2006.01301.x
- Carvalho, M. D. S., Taborda, C. P., & Gandra, R. F. (2010). Chromoblastomycosis: An overview of clinical manifestations, diagnosis, and treatment. Medical Mycology, 48(4), 505–510. https://doi.org/10.3109/13693780903178612
- Queiroz-Telles, F., Santos, D. W., & Salgado, C. G. (2009). Chromoblastomycosis: An etiological, epidemiological, clinical, diagnostic, and treatment update. PLoS Neglected Tropical Diseases, 3(8), e380. https://doi.org/10.1371/journal.pntd.0000380
- Santos, D. W., de Azevedo, C. M., Vicente, V. A., & Queiroz-Telles, F. (2007). Chromoblastomycosis: An important endemic disease of tropical and subtropical regions. Current Tropical Medicine Reports, 3(2), 79–85.
