Updates on Chromoblastomycosis: Evolving Insights in Clinical Management and Therapeutic Strategies

The aim of this review is to provide an in-depth overview of chromoblastomycosis, with emphasis on emerging management strategies and therapeutic options, and to underscore potential gaps in the literature and priorities for future research.

Among the newer triazoles, posaconazole has demonstrated greatest therapeutic potential in the treatment of chromoblastomycosis, including for severe and refractory disease. Adjunctive immunomodulatory therapies such as glucan, imiquimod, and acitretin have shown potential as well. Several novel and repurposed agents also have potential activity against dematiaceous fungi, including tricyclazole, HIV peptidase inhibitors, 1,10-phenanthroline-5,6-dione, and benzimidazoles. A recently proposed combination protocol with debulking, intralesional amphotericin B, and oral terbinafine (DAT protocol) achieved cure in all 16 included patients in a 2025 case series. While excisional surgery remains the preferred physical therapeutic modality, several reports have shown favorable results with both photodynamic and heat therapy.

Chromoblastomycosis continues to pose a therapeutic challenge, requiring prolonged antifungal therapy often combined with physical therapeutic modalities. Improved access to diagnostics and early intervention remain essential to reducing global disease burden.