Chromomycosis in Zaire.

Biopsy specimens from 17 Zairians with chromomycosis are described. Patients ranged in age from 20 to 50 years, with a mean of 37.2 (+/- 10.2). Chromomycosis was suspected clinically in only 3 of the 17 patients. In 14 patients the lesions were on the lower limbs and in 3 on the arms. The lesions were chronic, in one patient persisting for 9 years. The diagnosis was established in each patient by finding typical thick-walled brown fungi within the lesions. Some fungi were in abscesses, others were in histiocytes or giant cells. The fungi and the inflammatory reaction were concentrated in the upper dermis. Acanthosis, hyperkeratosis, and parakeratosis were constant features and pseudoepitheliomatous hyperplasia (PEH) was a feature in 10 patients. Transepithelial elimination (TEE) of fungi was a conspicuous feature in eight specimens. Microscopic features suggested TEE in an additional three. PEH and TEE were associated in all specimens. In patients with TEE, the diagnosis may be confirmed quickly by smearing surface scrapings and finding the characteristic brown fungi.