Chromoblastomycosis in Australia: an historical perspective

To study the histological features of a large series of patients with chromoblastomycosis to ascertain whether the earlier presentation of patients with this disease has resulted in any changes in the histological features that were recorded over 60 years ago.

A key word search of the database of our pathology laboratory over the period 1 January 2004 to 30 June 2012 was carried out for cases reported as chromoblastomycosis.

Seventy cases of chromoblastomycosis were reported over this period. A further four cases of subcutaneous chromomycosis were found in this search. They were excluded from the study because of their different aetiopathogenesis. Key histological features such as the presence of pseudoepitheliomatous hyperplasia, granulomas, suppurative granulomas, suppuration and the presence of brown (dematiaceous) sclerotic bodies were evaluated. Fewer cases showed pseudoepitheliomatous hyperplasia than in earlier studies. Sclerotic bodies were found easily in H&E sections in all cases, averting the need for any special stains. Only ten cases were submitted for culture; six grew Cladophialophora carionii and two Fonsecaea pedrosoi.

Chromoblastomycosis has changed little, histologically, since the original descriptions over 60 years ago, despite its much earlier clinical presentation these days. Pseudoepitheliomatous hyperplasia was seen in 77.1% of our cases, compared to its almost universal presence in cases reported many years ago that often presented after many years with the disease.