Chromoblastomycosis is a chronic fungal disease of the skin and subcutaneous tissues caused by dematiaceous fungi.
Ask a research question about Chromoblastomycosis. OpenScientist will conduct autonomous deep research using the Disorder Mechanisms Knowledge Base and PubMed literature (typically 10-30 minutes).
Do not include personal health information in your question. Questions and results are cached in your browser's local storage.
name: Chromoblastomycosis
creation_date: '2026-01-26T15:56:41Z'
updated_date: '2026-04-11T01:06:52Z'
category: Infectious Disease
description: >-
Chromoblastomycosis is a chronic fungal disease of the skin and subcutaneous
tissues caused by dematiaceous fungi.
disease_term:
term:
id: MONDO:0015908
label: chromomycosis
preferred_term: Chromoblastomycosis
parents:
- Infectious Disease
- Neglected tropical disease
infectious_agent:
- name: Fonsecaea pedrosoi
infectious_agent_term:
preferred_term: Fonsecaea pedrosoi
term:
id: NCBITaxon:40355
label: Fonsecaea pedrosoi
description: Dematiaceous fungus and common etiologic agent.
evidence:
- reference: PMID:20711281
reference_title: "Chromoblastomycosis Caused by Phialophora richardsiae."
supports: SUPPORT
snippet: "The most common etiologic agents are Fonsecaea pedrosoi and Cladophialophora carrionii, both of which can be isolated from plant debris."
explanation: The abstract identifies F. pedrosoi as a common etiologic agent.
- name: Cladophialophora carrionii
infectious_agent_term:
preferred_term: Cladophialophora carrionii
term:
id: NCBITaxon:86049
label: Cladophialophora carrionii
description: Dematiaceous fungus and common etiologic agent.
evidence:
- reference: PMID:20711281
reference_title: "Chromoblastomycosis Caused by Phialophora richardsiae."
supports: SUPPORT
snippet: "The most common etiologic agents are Fonsecaea pedrosoi and Cladophialophora carrionii, both of which can be isolated from plant debris."
explanation: The abstract identifies C. carrionii as a common etiologic agent.
transmission:
- name: Traumatic skin inoculation
description: Infection typically follows traumatic inoculation of the skin.
evidence:
- reference: PMID:20711281
reference_title: "Chromoblastomycosis Caused by Phialophora richardsiae."
supports: SUPPORT
snippet: "The infection usually follows traumatic inoculation by a penetrating thorn or splinter wound."
explanation: The abstract describes traumatic inoculation as the usual route.
phenotypes:
- name: Verrucous papule
category: Dermatologic
frequency: COMMON
phenotype_term:
preferred_term: Verrucous papule
term:
id: HP:0012500
label: Verrucous papule
evidence:
- reference: PMID:20711281
reference_title: "Chromoblastomycosis Caused by Phialophora richardsiae."
supports: SUPPORT
snippet: "Several months after the injury, painless papules or nodules appear on the affected area; these papules then progress to scaly and verrucose plaques."
explanation: The abstract describes papules that progress to verrucose plaques.
- name: Skin plaque
category: Dermatologic
frequency: COMMON
phenotype_term:
preferred_term: Skin plaque
term:
id: HP:0200035
label: Skin plaque
evidence:
- reference: PMID:20711281
reference_title: "Chromoblastomycosis Caused by Phialophora richardsiae."
supports: SUPPORT
snippet: "Several months after the injury, painless papules or nodules appear on the affected area; these papules then progress to scaly and verrucose plaques."
explanation: The abstract describes progression to verrucose plaques.
references:
- reference: DOI:10.1007/s12281-025-00504-z
title: The Current Landscape of Repurposed Drugs for Fungal Neglected Tropical Diseases
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: of Review Eumycetoma, chromoblastomycosis, and sporotrichosis are three of only four fungal infections recognized as Neglected Tropical Diseases (NTDs) by the World Health Organization.
supporting_text: of Review Eumycetoma, chromoblastomycosis, and sporotrichosis are three of only four fungal infections recognized as Neglected Tropical Diseases (NTDs) by the World Health Organization.
evidence:
- reference: DOI:10.1007/s12281-025-00504-z
reference_title: The Current Landscape of Repurposed Drugs for Fungal Neglected Tropical Diseases
supports: SUPPORT
evidence_source: OTHER
snippet: of Review Eumycetoma, chromoblastomycosis, and sporotrichosis are three of only four fungal infections recognized as Neglected Tropical Diseases (NTDs) by the World Health Organization.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.1038/s41577-022-00826-w
title: Immune responses to human fungal pathogens and therapeutic prospects
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Immune responses to human fungal pathogens and therapeutic prospects
supporting_text: Immune responses to human fungal pathogens and therapeutic prospects
- reference: DOI:10.1080/21501203.2023.2249010
title: Role of Dectin-1 in immune response of macrophages induced by <i>Fonsecaea monophora</i> wild strain and melanin-deficient mutant strain
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Role of Dectin-1 in immune response of macrophages induced by <i>Fonsecaea monophora</i> wild strain and melanin-deficient mutant strain
supporting_text: Role of Dectin-1 in immune response of macrophages induced by <i>Fonsecaea monophora</i> wild strain and melanin-deficient mutant strain
- reference: DOI:10.1186/s12879-025-11475-4
title: 'Chromoblastomycosis in Peru: a retrospective review of 13 cases'
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: 'Chromoblastomycosis in Peru: a retrospective review of 13 cases'
supporting_text: 'Chromoblastomycosis in Peru: a retrospective review of 13 cases'
- reference: DOI:10.1186/s12941-024-00718-y
title: Successful management of chromoblastomycosis utilizing conventional antifungal agents and imiquimod therapy
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Chromoblastomycosis (CBM), a chronic fungal infection affecting the skin and subcutaneous tissues, is predominantly caused by dematiaceous fungi in tropical and subtropical areas.
supporting_text: Chromoblastomycosis (CBM), a chronic fungal infection affecting the skin and subcutaneous tissues, is predominantly caused by dematiaceous fungi in tropical and subtropical areas.
evidence:
- reference: DOI:10.1186/s12941-024-00718-y
reference_title: Successful management of chromoblastomycosis utilizing conventional antifungal agents and imiquimod therapy
supports: SUPPORT
evidence_source: OTHER
snippet: Chromoblastomycosis (CBM), a chronic fungal infection affecting the skin and subcutaneous tissues, is predominantly caused by dematiaceous fungi in tropical and subtropical areas.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.1371/journal.pntd.0012562
title: A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Chromoblastomycosis, an implantation mycosis, is a neglected tropical disease that causes decreased quality of life, stigma, and disability.
supporting_text: Chromoblastomycosis, an implantation mycosis, is a neglected tropical disease that causes decreased quality of life, stigma, and disability.
evidence:
- reference: DOI:10.1371/journal.pntd.0012562
reference_title: A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group
supports: SUPPORT
evidence_source: OTHER
snippet: Chromoblastomycosis, an implantation mycosis, is a neglected tropical disease that causes decreased quality of life, stigma, and disability.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.1371/journal.pntd.0013499
title: Chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations, United States, 2016–2021
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Chromoblastomycosis and phaeohyphomycotic abscesses are infections of the skin and subcutaneous tissues caused by dematiaceous fungi; more rarely, phaeohyphomycotic brain abscesses can occur.
supporting_text: Chromoblastomycosis and phaeohyphomycotic abscesses are infections of the skin and subcutaneous tissues caused by dematiaceous fungi; more rarely, phaeohyphomycotic brain abscesses can occur.
evidence:
- reference: DOI:10.1371/journal.pntd.0013499
reference_title: Chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations, United States, 2016–2021
supports: SUPPORT
evidence_source: OTHER
snippet: Chromoblastomycosis and phaeohyphomycotic abscesses are infections of the skin and subcutaneous tissues caused by dematiaceous fungi; more rarely, phaeohyphomycotic brain abscesses can occur.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.1371/journal.pone.0322127
title: IL-18 production is required for the generation of a Th1 response during experimental chromoblastomycosis
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Chromoblastomycosis is a chronic fungal infection characterized by the formation of granulomatous lesions in the skin and subcutaneous tissues that begins after inoculation trauma.
supporting_text: Chromoblastomycosis is a chronic fungal infection characterized by the formation of granulomatous lesions in the skin and subcutaneous tissues that begins after inoculation trauma.
evidence:
- reference: DOI:10.1371/journal.pone.0322127
reference_title: IL-18 production is required for the generation of a Th1 response during experimental chromoblastomycosis
supports: SUPPORT
evidence_source: OTHER
snippet: Chromoblastomycosis is a chronic fungal infection characterized by the formation of granulomatous lesions in the skin and subcutaneous tissues that begins after inoculation trauma.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.3389/fmed.2024.1396224
title: 'Chromoblastomycosis caused by Alternaria infectoria, concurrent with myiasis, in a recipient of a kidney transplant: a compelling case report'
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Neglected tropical diseases (NTDs) pose a significant threat to the health of millions of people worldwide, particularly in impoverished populations in tropical and subtropical regions.
supporting_text: Neglected tropical diseases (NTDs) pose a significant threat to the health of millions of people worldwide, particularly in impoverished populations in tropical and subtropical regions.
evidence:
- reference: DOI:10.3389/fmed.2024.1396224
reference_title: 'Chromoblastomycosis caused by Alternaria infectoria, concurrent with myiasis, in a recipient of a kidney transplant: a compelling case report'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Neglected tropical diseases (NTDs) pose a significant threat to the health of millions of people worldwide, particularly in impoverished populations in tropical and subtropical regions.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.3390/jof10030168
title: 'Chromoblastomycosis in French Guiana: Epidemiology and Practices, 1955–2023'
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Chromoblastomycosis (CBM) is a chronic neglected fungal disease, usually met in tropical areas.
supporting_text: Chromoblastomycosis (CBM) is a chronic neglected fungal disease, usually met in tropical areas.
evidence:
- reference: DOI:10.3390/jof10030168
reference_title: 'Chromoblastomycosis in French Guiana: Epidemiology and Practices, 1955–2023'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Chromoblastomycosis (CBM) is a chronic neglected fungal disease, usually met in tropical areas.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.3390/jof9020224
title: 'Expanding the Toolbox for Functional Genomics in Fonsecaea pedrosoi: The Use of Split-Marker and Biolistic Transformation for Inactivation of Tryptophan Synthase (trpB) Gene'
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Chromoblastomycosis (CBM) is a disease caused by several dematiaceous fungi from different genera, and Fonsecaea is the most common which has been clinically isolated.
supporting_text: Chromoblastomycosis (CBM) is a disease caused by several dematiaceous fungi from different genera, and Fonsecaea is the most common which has been clinically isolated.
evidence:
- reference: DOI:10.3390/jof9020224
reference_title: 'Expanding the Toolbox for Functional Genomics in Fonsecaea pedrosoi: The Use of Split-Marker and Biolistic Transformation for Inactivation of Tryptophan Synthase (trpB) Gene'
supports: SUPPORT
evidence_source: OTHER
snippet: Chromoblastomycosis (CBM) is a disease caused by several dematiaceous fungi from different genera, and Fonsecaea is the most common which has been clinically isolated.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.3390/jof9121172
title: New Immunological Markers in Chromoblastomycosis—The Importance of PD-1 and PD-L1 Molecules in Human Infection
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: The pathogenesis of chromoblastomycosis (CBM) is associated with Th2 and/or T regulatory immune responses, while resistance is associated with a Th1 response.
supporting_text: The pathogenesis of chromoblastomycosis (CBM) is associated with Th2 and/or T regulatory immune responses, while resistance is associated with a Th1 response.
evidence:
- reference: DOI:10.3390/jof9121172
reference_title: New Immunological Markers in Chromoblastomycosis—The Importance of PD-1 and PD-L1 Molecules in Human Infection
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: The pathogenesis of chromoblastomycosis (CBM) is associated with Th2 and/or T regulatory immune responses, while resistance is associated with a Th1 response.
explanation: Deep research cited this publication as relevant literature for Chromoblastomycosis.
- reference: DOI:10.7759/cureus.73619
title: Treatment-Resistant Chromoblastomycosis Successfully Managed With Surgical Excision
found_in:
- Chromoblastomycosis-deep-research-falcon.md
findings:
- statement: Treatment-Resistant Chromoblastomycosis Successfully Managed With Surgical Excision
supporting_text: Treatment-Resistant Chromoblastomycosis Successfully Managed With Surgical Excision
Chromoblastomycosis (CBM) is a chronic implantation/subcutaneous mycosis caused by melanized (dematiaceous) fungi introduced via traumatic transcutaneous inoculation, producing slowly progressive, polymorphic skin/subcutaneous lesions and disability; diagnosis is defined by the presence of muriform (Medlar/sclerotic/“copper penny”) bodies on microscopy/histopathology. CBM is a WHO-designated neglected tropical disease (NTD) and a skin-NTD, but global burden estimates remain uncertain because surveillance and access to diagnostics/treatment are limited. (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2)
| Field | Value |
|---|---|
| Disease name | Chromoblastomycosis (smith2024aglobalchromoblastomycosis pages 1-2) |
| Category / disease class | Neglected tropical disease; specifically a skin-NTD; chronic implantation/subcutaneous mycosis caused by melanized (dematiaceous) fungi (smith2024aglobalchromoblastomycosis pages 1-2, smith2024aglobalchromoblastomycosis pages 2-3) |
| WHO NTD status | WHO designated chromoblastomycosis as a neglected tropical disease in 2017; included in the WHO Road Map for Neglected Tropical Diseases 2021–2030 and designated as an NTD “targeted for control” (smith2024aglobalchromoblastomycosis pages 1-2, smith2024aglobalchromoblastomycosis pages 2-3) |
| Common synonyms / alternate names found in context | Chromomycosis / chromomycosis; chromomycotic infection not explicitly found in available context; clinical literature also refers to “chromoblastomycosis (CBM)” (NCT06523998 chunk 1, NCT06523998 chunk 2, sanchezdiaz2025chromoblastomycosisinperu pages 1-2) |
| MeSH term | Chromoblastomycosis (NCT06523998 chunk 2) |
| MeSH ID | D002862 (from ClinicalTrials.gov derived MeSH browsing for a study including chromoblastomycosis/chromomycosis) (NCT06523998 chunk 2) |
| ICD-10 code(s) explicitly available in context | B43.0 = cutaneous chromoblastomycosis; B43.8 and B43.9 also reported as additional B43 chromoblastomycosis hospitalization codes in U.S. inpatient analysis (smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) |
| ICD-11 | Not found in available context/sources retrieved here (smith2024aglobalchromoblastomycosis pages 2-3, smith2025chromoblastomycosisandphaeohyphomycotic pages 6-8) |
| MONDO ID | Not found in available context/sources retrieved here (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2) |
| Orphanet ID | Not found in available context/sources retrieved here (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2) |
| Source granularity | Primarily aggregated disease-level resources and observational case series/hospitalization datasets; not derived solely from individual EHR patients (smith2024aglobalchromoblastomycosis pages 1-2, valentin2024chromoblastomycosisinfrench pages 1-2, smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) |
Table: This table summarizes the key classification terms, disease identifiers, and synonym information for chromoblastomycosis using only evidence available in the cited context. It is useful for normalizing a disease knowledge-base entry and documenting where identifier gaps remain.
Notes on identifier gaps: ICD-11, MONDO, and Orphanet IDs were not found in the retrieved full texts; additional retrieval from those specific terminologies would be required rather than inference. (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2)
Evidence summarized below comes from: - Aggregated disease-level strategy/gap-analysis for WHO NTD roadmap implementation. (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2) - Regional retrospective clinical series (French Guiana; Peru) and administrative hospitalization analyses (US). (valentin2024chromoblastomycosisinfrench pages 1-2, sanchezdiaz2025chromoblastomycosisinperu pages 1-2, smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) - Mechanistic studies in vitro and in murine experimental models, and review-level immunology synthesis. (ferreira2025il18productionis pages 1-2, zhong2024roleofdectin1 pages 1-2, lionakis2023immuneresponsesto pages 9-10)
Direct gene–environment interaction data were not identified in the retrieved clinical literature; strategy-level sources highlight traumatic inoculation and environmental reservoirs as key drivers and mention candidate host predisposition loci (Section 4/8). (smith2024aglobalchromoblastomycosis pages 2-3)
French Guiana (1955–2023; published Feb 2024): lesion types included cicatricial 21.7%, verrucous 21.7%, nodular 13%, tumoral 4.3%, plaque 4.3%, mixed 34.8%; severity: mild 13%, moderate 52.2%, severe 30.4%; symptoms: pruritus 26.1%, pain 17.4%. (valentin2024chromoblastomycosisinfrench pages 4-7, valentin2024chromoblastomycosisinfrench pages 2-4)
Peru (2011–2024; published Aug 2025): plaque-like and verrucous forms 38% each; tumoral and cicatricial 15% each; pruritus 84%, pain 30%; 30% reported functional limitations affecting work. (sanchezdiaz2025chromoblastomycosisinperu pages 1-2)
Anatomic distribution: lower limb predominance is consistent across series (e.g., 78.3% in French Guiana; 53% in Peru). (valentin2024chromoblastomycosisinfrench pages 2-4, sanchezdiaz2025chromoblastomycosisinperu pages 1-2)
1) Traumatic inoculation introduces melanized fungi into skin/subcutaneous tissue. (smith2024aglobalchromoblastomycosis pages 2-3) 2) Fungal adaptation includes formation of muriform cells with thickened pigmented cell walls, contributing to persistence and treatment refractoriness. (smith2024aglobalchromoblastomycosis pages 2-3) 3) Innate immune recognition is suboptimal in some models; a high-impact review describes modest CLR signaling via dectin-2/Mincle and failure to activate TLRs effectively, contributing to inadequate local inflammation. (lionakis2023immuneresponsesto pages 9-10) 4) Protective pathways include macrophage recognition/phagocytosis (e.g., Dectin-1-associated) and Th1/Th17 adaptive immunity; experimental work shows NLRP3→caspase-1→IL-18 supports Th1/IFN-γ-mediated fungal control. (ferreira2025il18productionis pages 1-2, zhong2024roleofdectin1 pages 1-2) 5) Chronicity may be reinforced by immunoregulatory/exhaustion mechanisms in human lesions (PD-1/PD-L1; IL-10/IL-17 patterns), impairing effective clearance. (cavallone2023newimmunologicalmarkers pages 6-9)
UBERON suggestions: skin of lower limb; subcutaneous adipose tissue; lymphatic vessel; (valentin2024chromoblastomycosisinfrench pages 2-4, sanchezdiaz2025chromoblastomycosisinperu pages 1-2)
| Study/setting | Publication date | Design | N | Key demographics | Diagnostic delay | Key diagnostic yields | Key outcomes/complications | URL |
|---|---|---|---|---|---|---|---|---|
| French Guiana, cases diagnosed 1955–2023 | Feb 2024 (valentin2024chromoblastomycosisinfrench pages 1-2, valentin2024chromoblastomycosisinfrench pages 2-4) | Retrospective observational series (valentin2024chromoblastomycosisinfrench pages 1-2) | 23 (valentin2024chromoblastomycosisinfrench pages 1-2) | 87% male; mean age 60 years; 87% lived in coastal areas; 74% had outdoor occupations; trauma reported in 39.1% (valentin2024chromoblastomycosisinfrench pages 2-4) | Median disease duration at diagnosis 4 years; range 2 months–20 years; 52.2% had lesions evolving ≥3 years (valentin2024chromoblastomycosisinfrench pages 2-4) | Direct microscopy positive 78.3% in abstract, while detailed series pages report 12/23 (52.2%); culture positive 69.6%; histopathology positive 22/23 (95.7%); 14 cultured isolates were Fonsecaea pedrosoi (valentin2024chromoblastomycosisinfrench pages 1-2, valentin2024chromoblastomycosisinfrench pages 4-7) | Complications in 13%: functional limitation, elephantiasis, and 1 squamous cell carcinoma requiring amputation; severe disease 30.4% (valentin2024chromoblastomycosisinfrench pages 2-4, valentin2024chromoblastomycosisinfrench pages 4-7) | https://doi.org/10.3390/jof10030168 (valentin2024chromoblastomycosisinfrench pages 1-2) |
| Peru, cases diagnosed 2011–2024 | Aug 2025 (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | Retrospective review of tertiary-center cases (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | 13 analyzable cases (15 identified) (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | 84% male; median age 65.3 years; 77% acquired infection in the Peruvian Amazon, including Ucayali 46% and San Martin 23% (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | Average disease duration 10.7 years; range 1–25 years (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | Confirmation by muriform cells on direct microscopy or histopathology; etiologic morphology identified in 9 patients; Fonsecaea spp. 46%, Cladophialophora 15%, Phialophora 7% (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | Lesions 2–50 cm; lower limbs 53%; plaque-like and verrucous forms each 38%; 46% had single lesions; treatment duration 5–136 months; cure 46%; misdiagnosis included leishmaniasis/tuberculosis (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) | https://doi.org/10.1186/s12879-025-11475-4 (sanchezdiaz2025chromoblastomycosisinperu pages 1-2) |
| United States hospitalizations, 2016–2021 | Sep 2025 (smith2025chromoblastomycosisandphaeohyphomycotic pages 1-3, smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) | HCUP National Inpatient Sample hospitalization analysis (smith2025chromoblastomycosisandphaeohyphomycotic pages 1-3, smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) | 690 hospitalization estimates for chromoblastomycosis/phaeohyphomycotic abscesses; 155 coded as cutaneous chromoblastomycosis B43.0 (smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) | Higher rates in males (0.4 vs 0.3 per 1,000,000); highest in age ≥65 years (0.9 per 1,000,000); highest regional rates in Northeast 0.5 and South 0.4 per 1,000,000 (smith2025chromoblastomycosisandphaeohyphomycotic pages 1-3, smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5) | Not reported; outpatient cases likely undercounted because NIS excludes outpatient visits (smith2025chromoblastomycosisandphaeohyphomycotic pages 6-8) | Administrative coding study; no direct microscopy/culture yield data reported (smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5, smith2025chromoblastomycosisandphaeohyphomycotic pages 6-8) | Mean hospital stay 9.9 days overall and 8.5 days for chromoblastomycosis; in-hospital mortality 3%; lymphedema in 14% of chromoblastomycosis hospitalizations / about 1 in 7 patients; common comorbidities: hypertension 34%, diabetes 33%, dyslipidemia 28%, CKD 21% (smith2025chromoblastomycosisandphaeohyphomycotic pages 1-3, smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5, smith2025chromoblastomycosisandphaeohyphomycotic pages 6-8) | https://doi.org/10.1371/journal.pntd.0013499 (smith2025chromoblastomycosisandphaeohyphomycotic pages 1-3) |
| Global burden / WHO strategy statements | Oct 2024 (smith2024aglobalchromoblastomycosis pages 1-2, smith2024aglobalchromoblastomycosis pages 2-3) | WHO roadmap-aligned strategy paper / expert gap assessment synthesis (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2) | Global case burden unknown; some researchers estimate >10,000 global cases (smith2024aglobalchromoblastomycosis pages 1-2) | No unified global demographic denominator because there is no national, regional, or global surveillance network (smith2024aglobalchromoblastomycosis pages 1-2) | Not quantifiable globally due to surveillance and diagnostic access gaps (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2) | No pooled diagnostic yields; WHO priorities include surveillance, affordable diagnostics/treatment, field manuals, training, and rapid diagnostics (smith2024aglobalchromoblastomycosis pages 2-3) | WHO designated chromoblastomycosis an NTD in 2017; included in WHO NTD Road Map 2021–2030 as “targeted for control”; 2023 gap assessment rated 5/11 dimensions orange and 6/11 red, indicating major unmet needs (smith2024aglobalchromoblastomycosis pages 2-3, smith2024aglobalchromoblastomycosis pages 1-2) | https://doi.org/10.1371/journal.pntd.0012562 (smith2024aglobalchromoblastomycosis pages 2-3) |
Table: This table compiles recent quantitative epidemiology, demographics, diagnostic yield, and outcome data for chromoblastomycosis across regional studies and global strategy sources. It is useful for comparing burden estimates, diagnostic delays, and complications across settings.
| Modality | What it detects | Key hallmark | Yield/sensitivity (if available) | Notes/real-world implementation | Key source (with PMID if present; if not in text, leave blank) | URL |
|---|---|---|---|---|---|---|
| Direct microscopy (KOH) | Muriform/sclerotic/fumagoid cells in skin scrapings or lesion material (ariani2023clinicalandmycological pages 6-9, ariani2023clinicalandmycological pages 9-11, smith2024aglobalchromoblastomycosis pages 4-6, valentin2024chromoblastomycosisinfrench pages 4-7, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | Pathognomonic round brown thick-walled “copper penny”/Medlar/muriform bodies; highest yield from lesions with black dots (ariani2023clinicalandmycological pages 6-9, ariani2023clinicalandmycological pages 9-11) | Reported sensitivity 90–100% in a 2023 case series; French Guiana series: 12/23 positive (52.2%) in detailed results, while abstract reports 78.3% (ariani2023clinicalandmycological pages 9-11, valentin2024chromoblastomycosisinfrench pages 4-7, valentin2024chromoblastomycosisinfrench pages 1-2) | Low-cost, high-yield method emphasized for resource-limited settings; training is important; vinyl adhesive tape sampling has been proposed for field use (smith2024aglobalchromoblastomycosis pages 4-6) | Ariani et al., 2023; Valentin et al., 2024; PMID not provided in context (ariani2023clinicalandmycological pages 9-11, valentin2024chromoblastomycosisinfrench pages 4-7) | https://doi.org/10.3390/jof10030168 |
| Histopathology | Tissue architecture plus fungal elements in biopsy sections (ariani2023clinicalandmycological pages 9-11, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5, valentin2024chromoblastomycosisinfrench pages 4-7) | Pseudoepitheliomatous hyperplasia/granulomatous inflammation with muriform bodies; “copper penny” cells in tissue (ariani2023clinicalandmycological pages 9-11, valentin2024chromoblastomycosisinfrench pages 4-7) | French Guiana: 22/23 positive (95.7%) (valentin2024chromoblastomycosisinfrench pages 4-7) | Often the highest-yield confirmatory modality in series; useful when direct exam/culture are negative or clinical differential includes SCC, atypical mycobacteria, or other deep mycoses (martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5, valentin2024chromoblastomycosisinfrench pages 4-7) | Valentin et al., 2024; Martinelli et al., 2024; PMID not provided in context (martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5, valentin2024chromoblastomycosisinfrench pages 4-7) | https://doi.org/10.3390/jof10030168 |
| Mycological culture | Viable dematiaceous fungus for genus/species identification (ariani2023clinicalandmycological pages 9-11, zheng2024successfulmanagementof pages 1-2, valentin2024chromoblastomycosisinfrench pages 4-7, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | Dark/black pigmented colonies; species-specific colony morphology on Sabouraud agar (ariani2023clinicalandmycological pages 9-11, zheng2024successfulmanagementof pages 1-2) | French Guiana: 16/23 positive (69.6%) (valentin2024chromoblastomycosisinfrench pages 4-7) | Enables etiologic identification (e.g., Fonsecaea pedrosoi, Alternaria infectoria); culture may be difficult to obtain in some settings and environmental cultures are challenging (valentin2024chromoblastomycosisinfrench pages 4-7, mahmoudi2024chromoblastomycosiscausedby pages 1-2, smith2024aglobalchromoblastomycosis pages 4-6) | Valentin et al., 2024; Mahmoudi et al., 2024; PMID not provided in context (valentin2024chromoblastomycosisinfrench pages 4-7, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | https://doi.org/10.3390/jof10030168 |
| ITS sequencing / NGS | Species-level molecular identification from isolates or tissue (zheng2024successfulmanagementof pages 1-2, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | ITS sequence match/homology identifying etiologic fungus (e.g., Fonsecaea monophora, Alternaria infectoria) (zheng2024successfulmanagementof pages 1-2, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | No pooled sensitivity reported in the cited case reports; one strategy paper notes molecular environmental tests/metagenomics may overcome culture limitations (zheng2024successfulmanagementof pages 1-2, mahmoudi2024chromoblastomycosiscausedby pages 1-2, smith2024aglobalchromoblastomycosis pages 4-6) | Used after culture or alongside advanced diagnostics; in one 2024 case, ITS plus NGS supported F. monophora identification; in another, ITS sequencing confirmed A. infectoria (zheng2024successfulmanagementof pages 1-2, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | Zheng et al., 2024; Mahmoudi et al., 2024; PMID not provided in context (zheng2024successfulmanagementof pages 1-2, mahmoudi2024chromoblastomycosiscausedby pages 1-2) | https://doi.org/10.1186/s12941-024-00718-y |
| Dermoscopy | Surface lesion patterns that help recognize CBM and target sampling sites (ariani2023clinicalandmycological pages 6-9, ariani2023clinicalandmycological pages 9-11, zheng2024successfulmanagementof pages 1-2) | Multiple irregular/reddish-black dots; yellowish-orange ovoid structures over pink/white areas (ariani2023clinicalandmycological pages 6-9, ariani2023clinicalandmycological pages 9-11, zheng2024successfulmanagementof pages 1-2) | No sensitivity/specificity reported in available context (ariani2023clinicalandmycological pages 9-11, zheng2024successfulmanagementof pages 1-2) | Noninvasive adjunct; can guide where to sample for KOH/culture; promising but not yet well validated and may be costly in some settings (smith2024aglobalchromoblastomycosis pages 4-6, zheng2024successfulmanagementof pages 1-2) | Ariani et al., 2023; Zheng et al., 2024; PMID not provided in context (ariani2023clinicalandmycological pages 9-11, zheng2024successfulmanagementof pages 1-2) | https://doi.org/10.1186/s12941-024-00718-y |
| Reflectance confocal microscopy (RCM) | In vivo microscopic reflectance patterns within lesions (zheng2024successfulmanagementof pages 1-2) | Small round hyperreflective bodies in the reported case (zheng2024successfulmanagementof pages 1-2) | No sensitivity/specificity reported in available context (zheng2024successfulmanagementof pages 1-2) | Reported as an adjunctive, noninvasive tool in a 2024 case; not established as a standard standalone test (zheng2024successfulmanagementof pages 1-2) | Zheng et al., 2024; PMID not provided in context (zheng2024successfulmanagementof pages 1-2) | https://doi.org/10.1186/s12941-024-00718-y |
| Antifungal susceptibility testing (AFST) | In vitro antifungal susceptibility / MICs of the isolate (zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 4-6) | Lower MICs for itraconazole/terbinafine than fluconazole/amphotericin in one case; strategy papers note need to monitor rising MICs/resistance (zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 6-7) | No standardized clinical sensitivity/yield reported; used selectively in case-level work (zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 6-7) | Performed with commercial panel (YeastOne) plus CLSI M38-A3 terbinafine assay in one 2024 case; global strategy recommends increased AFST and resistance surveillance (zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 6-7) | Zheng et al., 2024; Smith et al., 2024; PMID not provided in context (zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 6-7) | https://doi.org/10.1186/s12941-024-00718-y |
Table: This table summarizes the main diagnostic modalities used for chromoblastomycosis, what each test detects, and the quantitative evidence available from recent studies. It is useful for comparing real-world diagnostic yield and understanding how microscopy, pathology, culture, and newer adjunctive tools fit together in practice.
Cropped figures from a 2024 French Guiana series illustrate KOH microscopy fumagoid cells and histopathology “copper penny” bodies in tissue. (valentin2024chromoblastomycosisinfrench media 4ac5c53a, valentin2024chromoblastomycosisinfrench media f433a202, valentin2024chromoblastomycosisinfrench media 91754828)
| Intervention (drug/procedure) | Mechanism/class | Typical dose/duration (as reported) | Evidence type (case series/case report/review/strategy) | Reported outcomes/response rates | Notes/implementation considerations | MAXO term suggestion | CHEBI/Drug name where applicable | Key source (citation ID) and URL |
|---|---|---|---|---|---|---|---|---|
| Itraconazole | Triazole antifungal; inhibits ergosterol biosynthesis | Commonly 200–400 mg/day; prolonged therapy for at least 6–12 months in case-series/review data; months to years may be required (ariani2023clinicalandmycological pages 9-11, farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | Case series, retrospective series, review, strategy (ariani2023clinicalandmycological pages 9-11, sanchezdiaz2025chromoblastomycosisinperu pages 1-2, farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | Most widely used systemic agent; Peruvian series mainly used itraconazole-based regimens with overall cure in 46%; monotherapy in French Guiana produced one cure with relapse at 18 months and one partial remission (sanchezdiaz2025chromoblastomycosisinperu pages 1-2, valentin2024chromoblastomycosisinfrench pages 4-7) | First-line systemic option but long duration, relapse, cost/access issues, and drug interactions/toxicity can limit use; QT prolongation caused discontinuation in one case (smith2024aglobalchromoblastomycosis pages 2-3, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | MAXO: antifungal pharmacotherapy | CHEBI: itraconazole | (sanchezdiaz2025chromoblastomycosisinperu pages 1-2, farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) https://doi.org/10.1186/s12879-025-11475-4 ; https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.3390/jof10030168 ; https://doi.org/10.7759/cureus.73619 |
| Terbinafine | Allylamine antifungal; inhibits squalene epoxidase | 250–1000 mg/day reported; review cites 500 mg/day commonly; often prolonged (ariani2023clinicalandmycological pages 9-11, farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 4-7) | Case series, retrospective series, review (ariani2023clinicalandmycological pages 9-11, farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 4-7) | French Guiana: terbinafine ± cryotherapy in 8 patients led to 2 improvements, 1 cure, 2 ongoing treatment, 3 lost to follow-up; single-case forearm lesion failed terbinafine 250 mg/day for 3 months (valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | Considered a first-line systemic alternative with itraconazole; useful alone or with cryotherapy/surgery, but responses are variable and relapses occur (valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | MAXO: antifungal pharmacotherapy | CHEBI: terbinafine | (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.3390/jof10030168 ; https://doi.org/10.7759/cureus.73619 |
| Itraconazole + terbinafine | Combination systemic antifungal therapy | Review reports itraconazole 200–400 mg/day with terbinafine 500 mg/day; one 2024 case used itraconazole 200 mg daily + terbinafine 250 mg daily for 3 months before imiquimod was added (farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2) | Review, case report, retrospective series (farid2025thecurrentlandscape pages 2-4, sanchezdiaz2025chromoblastomycosisinperu pages 2-5, zheng2024successfulmanagementof pages 1-2) | Reported success rates range from 15% to 80% depending on severity/species; considered synergistic and useful in refractory disease; in one case regimen alone was subtherapeutic until imiquimod was added (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, zheng2024successfulmanagementof pages 1-2) | Combination often used to hasten response or in refractory disease; evidence is heterogeneous and based on small studies/case reports (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | MAXO: combination antifungal pharmacotherapy | CHEBI: itraconazole; terbinafine | (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5, zheng2024successfulmanagementof pages 1-2) https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.3390/jof10030168 ; https://doi.org/10.1186/s12879-025-11475-4 ; https://doi.org/10.1186/s12941-024-00718-y |
| Itraconazole + 5-flucytosine | Combination azole + antimetabolite antifungal | French Guiana: itraconazole 200–400 mg/day plus 5-fluorocytosine; used notably in 1982–1990 cases (valentin2024chromoblastomycosisinfrench pages 4-7) | Retrospective series, review (valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7) | French Guiana: 5 patients received regimen; outcomes included 1 relapse at 3 months, 2 therapy switches, 2 lost to follow-up; one later received itraconazole maintenance and achieved complete response (valentin2024chromoblastomycosisinfrench pages 4-7) | Can be effective but limited by 5-flucytosine toxicity; older regimen less favored now compared with itraconazole/terbinafine-based approaches (valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7) | MAXO: combination antifungal pharmacotherapy | CHEBI: itraconazole; flucytosine | (valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7) https://doi.org/10.3390/jof10030168 |
| Posaconazole | Extended-spectrum triazole antifungal | 400–800 mg/day reported for refractory chronic lesions (farid2025thecurrentlandscape pages 2-4) | Review; cited case reports/series (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 12-12) | Used successfully in refractory disease; review notes refractory cases responsive to posaconazole, but no pooled cure rate available in context (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | Reserved mainly for refractory cases or intolerance/failure of first-line therapy; access/cost may be limiting (smith2024aglobalchromoblastomycosis pages 3-4, farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | MAXO: antifungal pharmacotherapy | CHEBI: posaconazole | (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 12-12) https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.3390/jof10030168 |
| Voriconazole | Extended-spectrum triazole antifungal | 200–400 mg/day reported in review; one case of concurrent CBM/eumycetoma used 200 mg twice daily for 4 weeks with improvement; one 2024 susceptibility profile showed lower MIC than itraconazole/terbinafine (farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2) | Review, case report (farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2) | Reported as successful in refractory chronic lesions; short-course case report showed gradual clinical improvement after 4 weeks (farid2025thecurrentlandscape pages 2-4) | Alternative triazole for refractory/intolerance settings; strategy papers call for further study of voriconazole and posaconazole (smith2024aglobalchromoblastomycosis pages 3-4, farid2025thecurrentlandscape pages 2-4) | MAXO: antifungal pharmacotherapy | CHEBI: voriconazole | (smith2024aglobalchromoblastomycosis pages 3-4, farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2) https://doi.org/10.1371/journal.pntd.0012562 ; https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.1186/s12941-024-00718-y |
| Cryotherapy | Physical tissue destruction by freezing | Number of sessions varies; one case had 3 sessions with liquid nitrogen; often combined with itraconazole or terbinafine (sanchezdiaz2025chromoblastomycosisinperu pages 2-5, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | Retrospective series, case report, review (valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | Common adjunct; Peruvian series predominantly used itraconazole + cryosurgery; however relapse is frequent, and one case had little/no improvement after 3 sessions (sanchezdiaz2025chromoblastomycosisinperu pages 2-5, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | High relapse indices and risk of disfiguring scars noted in review; most useful as adjunct in localized disease (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | MAXO: cryotherapy | CHEBI: not applicable | (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.3390/jof10030168 ; https://doi.org/10.1186/s12879-025-11475-4 ; https://doi.org/10.7759/cureus.73619 |
| Surgery (wide excision / Mohs / excision with margins) | Surgical removal of infected tissue | Recommended for early/localized lesions; one case used wide local excision with 0.5 cm margins to fascia; Mohs noted as effective in review (valentin2024chromoblastomycosisinfrench pages 9-10, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | Retrospective series, case report, review/strategy (valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | French Guiana: 3 early surgical patients cured without recurrence; 1 long-standing case relapsed after surgery. Wide excision case had clear margins and no recurrence at 3 months. Mohs described as having excellent efficacy and no distant recurrence in cited review context (valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) | Best for recent, limited lesions; delayed diagnosis and deep lesions may preclude safe excision; often combined with systemic antifungals (valentin2024chromoblastomycosisinfrench pages 1-2, valentin2024chromoblastomycosisinfrench pages 9-10) | MAXO: surgical excision | CHEBI: not applicable | (valentin2024chromoblastomycosisinfrench pages 1-2, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 4-7, martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5) https://doi.org/10.3390/jof10030168 ; https://doi.org/10.7759/cureus.73619 |
| Thermotherapy / local heat | Physical heat-based local therapy | Exact temperature schedules not detailed in available context; appears as adjunct with systemic therapy in some regimens (valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5) | Review, retrospective series (valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5) | Mentioned as adjuvant/local therapy; no pooled response rate available in retrieved context (valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5) | Included among physical methods alongside cryotherapy and surgery; evidence less robust than for itraconazole/terbinafine-based therapy (valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5) | MAXO: thermotherapy | CHEBI: not applicable | (valentin2024chromoblastomycosisinfrench pages 9-10, sanchezdiaz2025chromoblastomycosisinperu pages 2-5) https://doi.org/10.3390/jof10030168 ; https://doi.org/10.1186/s12879-025-11475-4 |
| Photodynamic therapy (ALA-PDT) | Light-activated local therapy using aminolevulinic acid photosensitization | Review cites 4–9 sessions in refractory cases; another review notes ~6 applications in 10 patients (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | Review / cited case series (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 12-12) | Lesion size reportedly reduced by 80–90% after six applications in 10 patients; refractory cases improved after 4–9 sessions (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10) | Promising adjunct, especially for refractory hyperkeratotic disease; evidence remains from small series/case reports (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 12-12) | MAXO: photodynamic therapy | CHEBI: 5-aminolevulinic acid | (farid2025thecurrentlandscape pages 2-4, valentin2024chromoblastomycosisinfrench pages 9-10, valentin2024chromoblastomycosisinfrench pages 12-12) https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.3390/jof10030168 |
| Topical imiquimod adjunct | TLR7 agonist immune-response modifier | Topical 5% imiquimod, 0.6 g every other day in one 2024 case; used with itraconazole ± terbinafine (zheng2024successfulmanagementof pages 1-2) | Case report, review (farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2, lionakis2023immuneresponsesto pages 9-10) | Review cites lesion improvement in four patients and complete recovery in three patients with non-extensive lesions; 2024 case showed serial improvement after adding imiquimod to systemic antifungals (farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2) | May augment weak innate/TLR activation and reduce scar hyperplasia; evidence remains limited but mechanistically attractive for refractory disease (zheng2024successfulmanagementof pages 1-2, lionakis2023immuneresponsesto pages 9-10) | MAXO: topical immunomodulatory therapy | CHEBI: imiquimod | (farid2025thecurrentlandscape pages 2-4, zheng2024successfulmanagementof pages 1-2, lionakis2023immuneresponsesto pages 9-10) https://doi.org/10.1007/s12281-025-00504-z ; https://doi.org/10.1186/s12941-024-00718-y ; https://doi.org/10.1038/s41577-022-00826-w |
| AFST-guided therapy / susceptibility-informed antifungal selection | In vitro MIC-based treatment support | No universal dose; one 2024 case used Sensititre YeastOne plus CLSI M38-A3 terbinafine assay; lower MICs for itraconazole/terbinafine than fluconazole/amphotericin, with voriconazole lower still (zheng2024successfulmanagementof pages 1-2) | Case report, strategy/review (zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 6-7) | No formal response rate; strategy papers emphasize need for AFST and surveillance because resistance/rising MICs are concerns (smith2024aglobalchromoblastomycosis pages 4-6, smith2024aglobalchromoblastomycosis pages 6-7) | Useful for refractory or relapsing disease and for evaluating alternative triazoles; lack of standardized testing and limited culture recovery constrain routine use (smith2024aglobalchromoblastomycosis pages 4-6, smith2024aglobalchromoblastomycosis pages 6-7) | MAXO: antimicrobial susceptibility testing-guided therapy | CHEBI: not applicable | (smith2024aglobalchromoblastomycosis pages 4-6, zheng2024successfulmanagementof pages 1-2, smith2024aglobalchromoblastomycosis pages 6-7) https://doi.org/10.1186/s12941-024-00718-y ; https://doi.org/10.1371/journal.pntd.0012562 |
Table: This table summarizes the main drug and procedural treatments reported for chromoblastomycosis, including typical dosing, outcome data, and implementation caveats from the retrieved context. It is useful for comparing first-line, adjunctive, and refractory-disease management options.
No naturally occurring veterinary/chronic chromoblastomycosis burden in non-human species was identified in the retrieved sources. This section requires additional targeted veterinary literature retrieval.
References
(smith2024aglobalchromoblastomycosis pages 2-3): Dallas J. Smith, Flávio Queiroz-Telles, Fahafahantsoa Rapelanoro Rabenja, Roderick Hay, Alexandro Bonifaz, Marlous L. Grijsen, Romain Blaizot, Fernando Messina, Yinggai Song, Shawn R. Lockhart, Alexander Jordan, Alyson M. Cavanaugh, Anastasia P. Litvintseva, Tom Chiller, Marco Schito, Sybren de Hoog, Vania Aparecida Vicente, Muriel Cornet, Daniel Argaw Dagne, Lala S. Ramarozatovo, Conceição de Maria Pedrozo e Silva de Azevedo, and Daniel Wagner C. L. Santos. A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group. PLOS Neglected Tropical Diseases, 18:e0012562, Oct 2024. URL: https://doi.org/10.1371/journal.pntd.0012562, doi:10.1371/journal.pntd.0012562. This article has 23 citations and is from a domain leading peer-reviewed journal.
(smith2024aglobalchromoblastomycosis pages 1-2): Dallas J. Smith, Flávio Queiroz-Telles, Fahafahantsoa Rapelanoro Rabenja, Roderick Hay, Alexandro Bonifaz, Marlous L. Grijsen, Romain Blaizot, Fernando Messina, Yinggai Song, Shawn R. Lockhart, Alexander Jordan, Alyson M. Cavanaugh, Anastasia P. Litvintseva, Tom Chiller, Marco Schito, Sybren de Hoog, Vania Aparecida Vicente, Muriel Cornet, Daniel Argaw Dagne, Lala S. Ramarozatovo, Conceição de Maria Pedrozo e Silva de Azevedo, and Daniel Wagner C. L. Santos. A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group. PLOS Neglected Tropical Diseases, 18:e0012562, Oct 2024. URL: https://doi.org/10.1371/journal.pntd.0012562, doi:10.1371/journal.pntd.0012562. This article has 23 citations and is from a domain leading peer-reviewed journal.
(martinelli2024treatmentresistantchromoblastomycosissuccessfully pages 2-5): Matthew B Martinelli, Clay J Cockerell, and Philip R Cohen. Treatment-resistant chromoblastomycosis successfully managed with surgical excision. Cureus, Nov 2024. URL: https://doi.org/10.7759/cureus.73619, doi:10.7759/cureus.73619. This article has 4 citations.
(smith2025chromoblastomycosisandphaeohyphomycotic pages 1-3): Dallas J. Smith, Kaitlin Benedict, Shawn R. Lockhart, and Sanjay G. Revankar. Chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations, united states, 2016–2021. PLOS Neglected Tropical Diseases, 19:e0013499, Sep 2025. URL: https://doi.org/10.1371/journal.pntd.0013499, doi:10.1371/journal.pntd.0013499. This article has 1 citations and is from a domain leading peer-reviewed journal.
(NCT06523998 chunk 1): Daniel Barquero Orias. A Study on Rare Dermatological Infections Conducted at Three Major Reference Hospitals in Costa Rica.. Caja Costarricense de Seguro Social. 2023. ClinicalTrials.gov Identifier: NCT06523998
(NCT06523998 chunk 2): Daniel Barquero Orias. A Study on Rare Dermatological Infections Conducted at Three Major Reference Hospitals in Costa Rica.. Caja Costarricense de Seguro Social. 2023. ClinicalTrials.gov Identifier: NCT06523998
(sanchezdiaz2025chromoblastomycosisinperu pages 1-2): Mercedes Sanchez-Diaz, Nicolas Antunez de Mayolo, Cesar Ramos, Omayra Chincha, and Beatriz Bustamante. Chromoblastomycosis in peru: a retrospective review of 13 cases. BMC Infectious Diseases, Aug 2025. URL: https://doi.org/10.1186/s12879-025-11475-4, doi:10.1186/s12879-025-11475-4. This article has 1 citations and is from a peer-reviewed journal.
(smith2025chromoblastomycosisandphaeohyphomycotic pages 3-5): Dallas J. Smith, Kaitlin Benedict, Shawn R. Lockhart, and Sanjay G. Revankar. Chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations, united states, 2016–2021. PLOS Neglected Tropical Diseases, 19:e0013499, Sep 2025. URL: https://doi.org/10.1371/journal.pntd.0013499, doi:10.1371/journal.pntd.0013499. This article has 1 citations and is from a domain leading peer-reviewed journal.
(smith2025chromoblastomycosisandphaeohyphomycotic pages 6-8): Dallas J. Smith, Kaitlin Benedict, Shawn R. Lockhart, and Sanjay G. Revankar. Chromoblastomycosis and phaeohyphomycotic abscess-associated hospitalizations, united states, 2016–2021. PLOS Neglected Tropical Diseases, 19:e0013499, Sep 2025. URL: https://doi.org/10.1371/journal.pntd.0013499, doi:10.1371/journal.pntd.0013499. This article has 1 citations and is from a domain leading peer-reviewed journal.
(valentin2024chromoblastomycosisinfrench pages 1-2): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(ferreira2025il18productionis pages 1-2): L. Ferreira and S. R. de Almeida. Il-18 production is required for the generation of a th1 response during experimental chromoblastomycosis. PLOS One, May 2025. URL: https://doi.org/10.1371/journal.pone.0322127, doi:10.1371/journal.pone.0322127. This article has 0 citations and is from a peer-reviewed journal.
(zhong2024roleofdectin1 pages 1-2): Jiaojiao Zhong, Jing Zhang, Jianchi Ma, Wen-ying Cai, Xi-qing Li, and Junmin Zhang. Role of dectin-1 in immune response of macrophages induced by fonsecaea monophora wild strain and melanin-deficient mutant strain. Mycology, 15:45-56, Sep 2024. URL: https://doi.org/10.1080/21501203.2023.2249010, doi:10.1080/21501203.2023.2249010. This article has 5 citations.
(lionakis2023immuneresponsesto pages 9-10): Michail S. Lionakis, Rebecca A. Drummond, and Tobias M. Hohl. Immune responses to human fungal pathogens and therapeutic prospects. Nature Reviews. Immunology, 23:1-20, Jan 2023. URL: https://doi.org/10.1038/s41577-022-00826-w, doi:10.1038/s41577-022-00826-w. This article has 349 citations.
(valentin2024chromoblastomycosisinfrench pages 2-4): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(smith2024aglobalchromoblastomycosis pages 6-7): Dallas J. Smith, Flávio Queiroz-Telles, Fahafahantsoa Rapelanoro Rabenja, Roderick Hay, Alexandro Bonifaz, Marlous L. Grijsen, Romain Blaizot, Fernando Messina, Yinggai Song, Shawn R. Lockhart, Alexander Jordan, Alyson M. Cavanaugh, Anastasia P. Litvintseva, Tom Chiller, Marco Schito, Sybren de Hoog, Vania Aparecida Vicente, Muriel Cornet, Daniel Argaw Dagne, Lala S. Ramarozatovo, Conceição de Maria Pedrozo e Silva de Azevedo, and Daniel Wagner C. L. Santos. A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group. PLOS Neglected Tropical Diseases, 18:e0012562, Oct 2024. URL: https://doi.org/10.1371/journal.pntd.0012562, doi:10.1371/journal.pntd.0012562. This article has 23 citations and is from a domain leading peer-reviewed journal.
(valentin2024chromoblastomycosisinfrench pages 4-7): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(smith2024aglobalchromoblastomycosis pages 4-6): Dallas J. Smith, Flávio Queiroz-Telles, Fahafahantsoa Rapelanoro Rabenja, Roderick Hay, Alexandro Bonifaz, Marlous L. Grijsen, Romain Blaizot, Fernando Messina, Yinggai Song, Shawn R. Lockhart, Alexander Jordan, Alyson M. Cavanaugh, Anastasia P. Litvintseva, Tom Chiller, Marco Schito, Sybren de Hoog, Vania Aparecida Vicente, Muriel Cornet, Daniel Argaw Dagne, Lala S. Ramarozatovo, Conceição de Maria Pedrozo e Silva de Azevedo, and Daniel Wagner C. L. Santos. A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group. PLOS Neglected Tropical Diseases, 18:e0012562, Oct 2024. URL: https://doi.org/10.1371/journal.pntd.0012562, doi:10.1371/journal.pntd.0012562. This article has 23 citations and is from a domain leading peer-reviewed journal.
(smith2024aglobalchromoblastomycosis pages 3-4): Dallas J. Smith, Flávio Queiroz-Telles, Fahafahantsoa Rapelanoro Rabenja, Roderick Hay, Alexandro Bonifaz, Marlous L. Grijsen, Romain Blaizot, Fernando Messina, Yinggai Song, Shawn R. Lockhart, Alexander Jordan, Alyson M. Cavanaugh, Anastasia P. Litvintseva, Tom Chiller, Marco Schito, Sybren de Hoog, Vania Aparecida Vicente, Muriel Cornet, Daniel Argaw Dagne, Lala S. Ramarozatovo, Conceição de Maria Pedrozo e Silva de Azevedo, and Daniel Wagner C. L. Santos. A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group. PLOS Neglected Tropical Diseases, 18:e0012562, Oct 2024. URL: https://doi.org/10.1371/journal.pntd.0012562, doi:10.1371/journal.pntd.0012562. This article has 23 citations and is from a domain leading peer-reviewed journal.
(cavallone2023newimmunologicalmarkers pages 6-9): Italo N. Cavallone, Walter Belda, Caroline Heleno C. de Carvalho, Marcia D. Laurenti, and Luiz Felipe D. Passero. New immunological markers in chromoblastomycosis—the importance of pd-1 and pd-l1 molecules in human infection. Journal of Fungi, 9:1172, Dec 2023. URL: https://doi.org/10.3390/jof9121172, doi:10.3390/jof9121172. This article has 3 citations.
(favilla2023expandingthetoolbox pages 1-2): Luísa Dan Favilla, Tatiana Sobianski Herman, Camila da Silva Goersch, Rosangela Vieira de Andrade, Maria Sueli Soares Felipe, Anamélia Lorenzetti Bocca, and Larissa Fernandes. Expanding the toolbox for functional genomics in fonsecaea pedrosoi: the use of split-marker and biolistic transformation for inactivation of tryptophan synthase (trpb) gene. Journal of Fungi, 9:224, Feb 2023. URL: https://doi.org/10.3390/jof9020224, doi:10.3390/jof9020224. This article has 1 citations.
(favilla2023expandingthetoolbox pages 12-13): Luísa Dan Favilla, Tatiana Sobianski Herman, Camila da Silva Goersch, Rosangela Vieira de Andrade, Maria Sueli Soares Felipe, Anamélia Lorenzetti Bocca, and Larissa Fernandes. Expanding the toolbox for functional genomics in fonsecaea pedrosoi: the use of split-marker and biolistic transformation for inactivation of tryptophan synthase (trpb) gene. Journal of Fungi, 9:224, Feb 2023. URL: https://doi.org/10.3390/jof9020224, doi:10.3390/jof9020224. This article has 1 citations.
(ariani2023clinicalandmycological pages 6-9): T Ariani, Y Rizal, and RL Veroci. Clinical and mycological spectrum of chromoblastomycosis: a case series. Unknown journal, 2023.
(ariani2023clinicalandmycological pages 9-11): T Ariani, Y Rizal, and RL Veroci. Clinical and mycological spectrum of chromoblastomycosis: a case series. Unknown journal, 2023.
(mahmoudi2024chromoblastomycosiscausedby pages 1-2): Hamidreza Mahmoudi, Zahra Ramezanalipour, Mahmoud Khansari, Eelco F. J. Meijer, Shahram Mahmoudi, Bram Spruijtenburg, Abbas Rahimi Foroushani, Mohsen Gramishoar, and Hasti Kamali Sarvestani. Chromoblastomycosis caused by alternaria infectoria, concurrent with myiasis, in a recipient of a kidney transplant: a compelling case report. Frontiers in Medicine, Jul 2024. URL: https://doi.org/10.3389/fmed.2024.1396224, doi:10.3389/fmed.2024.1396224. This article has 2 citations.
(zheng2024successfulmanagementof pages 1-2): Jinjin Zheng, Shougang Liu, Zhenmou Xie, Yangxia Chen, Liyan Xi, Hongfang Liu, and Yinghui Liu. Successful management of chromoblastomycosis utilizing conventional antifungal agents and imiquimod therapy. Annals of Clinical Microbiology and Antimicrobials, Jun 2024. URL: https://doi.org/10.1186/s12941-024-00718-y, doi:10.1186/s12941-024-00718-y. This article has 6 citations and is from a peer-reviewed journal.
(valentin2024chromoblastomycosisinfrench media 4ac5c53a): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(valentin2024chromoblastomycosisinfrench media f433a202): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(valentin2024chromoblastomycosisinfrench media 91754828): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(valentin2024chromoblastomycosisinfrench pages 9-10): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.
(farid2025thecurrentlandscape pages 1-2): Tahsin Farid, Keyla C. Tumas, Heather A. Stone, and Mili Duggal. The current landscape of repurposed drugs for fungal neglected tropical diseases. Current Fungal Infection Reports, May 2025. URL: https://doi.org/10.1007/s12281-025-00504-z, doi:10.1007/s12281-025-00504-z. This article has 1 citations.
(farid2025thecurrentlandscape pages 2-4): Tahsin Farid, Keyla C. Tumas, Heather A. Stone, and Mili Duggal. The current landscape of repurposed drugs for fungal neglected tropical diseases. Current Fungal Infection Reports, May 2025. URL: https://doi.org/10.1007/s12281-025-00504-z, doi:10.1007/s12281-025-00504-z. This article has 1 citations.
(sanchezdiaz2025chromoblastomycosisinperu pages 2-5): Mercedes Sanchez-Diaz, Nicolas Antunez de Mayolo, Cesar Ramos, Omayra Chincha, and Beatriz Bustamante. Chromoblastomycosis in peru: a retrospective review of 13 cases. BMC Infectious Diseases, Aug 2025. URL: https://doi.org/10.1186/s12879-025-11475-4, doi:10.1186/s12879-025-11475-4. This article has 1 citations and is from a peer-reviewed journal.
(valentin2024chromoblastomycosisinfrench pages 12-12): Julie Valentin, Geoffrey Grotta, Thibaut Muller, Pieter Bourgeois, Kinan Drak Alsibai, Magalie Demar, Pierre Couppie, and Romain Blaizot. Chromoblastomycosis in french guiana: epidemiology and practices, 1955–2023. Journal of Fungi, 10:168, Feb 2024. URL: https://doi.org/10.3390/jof10030168, doi:10.3390/jof10030168. This article has 7 citations.