Department of Dermatology, Hangzhou Third People's Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.
PLoS Negl Trop Dis. 2022 Sep 26;16(9):e0010800. doi: 10.1371/journal.pntd.0010800. eCollection 2022 Sep.
Chromoblastomycosis (CBM) is a chronic fungal infection of the cutaneous and subcutaneous tissues caused by brown pigmented fungi. Fonsecaea monophora is one of the most common pathogens of CBM in China. Most formal cases have been reported from Southern China, however, the infection is not uncommon in Eastern China where very few case series are available. To describe the clinical aspects of CBM, we report a series of 11 cases between 2018 and 2021 at a single medical center in Eastern China. The patients were predominately male (n = 9) and the disease duration ranged from 3 months to 20 years. Plaque type lesions were the most common clinical manifestations. There were 7 cases of mild forms and 3 cases of severe forms. Among the 3 severe cases, one case gave up treatment due to economic poverty; one case did not respond to a 1-year systemic treatmen; one case was cured by combination therapy of 10 months. Other cases were cured by treatment with antifungal agents. All cases of direct mycological examination were positive. All isolates were identified by morphology and sequencing of the the ITS regions of ribosomal DNA, Ten were F. monophora and 1 was Cladophialophora carrionii. All cases had been evaluated at other clinics, where 8 cases were misdiagnosed as other diseases. As a neglected tropical disease (NTD), CBM is still a major challenge in the field of dermatology, especially in its severe clinical forms. As an effective and simple diagnostic method of CBM, direct microscopic examination should be further promoted in rural hospitals.
着色芽生菌病（CBM）是一种由棕色色素真菌引起的皮肤和皮下组织的慢性真菌感染。单端孢霉是中国 CBM 的最常见病原体之一。大多数确诊病例都来自中国南方，但在中国东部，这种感染并不罕见，然而，那里很少有病例系列报告。为了描述 CBM 的临床特征，我们报告了 2018 年至 2021 年期间在华东地区一家医疗中心的 11 例病例系列。患者主要为男性（n = 9），疾病持续时间从 3 个月到 20 年不等。斑块型病变是最常见的临床表现。有 7 例为轻度，3 例为重度。在 3 例重度病例中，1 例因经济贫困而放弃治疗；1 例对 1 年的系统治疗无反应；1 例经 10 个月的联合治疗治愈。其他病例经抗真菌药物治疗治愈。所有直接真菌学检查均为阳性。所有分离株均通过形态学和核糖体 DNA 的 ITS 区序列鉴定，10 株为单端孢霉，1 株为拟卡利奥皮拉氏菌。所有病例均在其他诊所进行了评估，其中 8 例被误诊为其他疾病。作为一种被忽视的热带病（NTD），CBM 仍然是皮肤科领域的一个主要挑战，特别是在其严重的临床形式。作为 CBM 的一种有效且简单的诊断方法，直接显微镜检查应在农村医院进一步推广。
