Chromoblastomycosis with Squamous Cell Carcinoma.

Area of Science:

• Mycology
• Dermatology
• Oncology

Background:

• Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue.
• It is caused by dematiaceous fungi, often from the genus Cladosporium.
• Long-standing chromoblastomycosis can undergo malignant transformation.

Observation:

• A 47-year-old male presented with a 33-year history of verrucous lesions on his right upper limb.
• One lesion ulcerated and persisted for 6 years.
• Histopathological and mycological examination confirmed chromoblastomycosis due to Cladosporium cladosporioides.

Findings:

• Combined treatment with amphotericin B and 5-fluorouracil partially resolved lesions.
• The persistent ulcer revealed a low-grade squamous cell carcinoma, treated with surgery.
• Metastasis to axillary lymph nodes occurred, showing fungal granuloma, and was treated with radiation and chemotherapy.

Implications:

• This case underscores the potential for chromoblastomycosis to develop into squamous cell carcinoma.
• It highlights the challenges in managing extensive, long-standing fungal infections and their complications.
• Effective multidisciplinary approaches are crucial for such complex cases.