Chromoblastomycosis presenting as a phagedenic ulcer on the face.

BACKGROUND: Chromoblastomycosis is a chronic fungal infection which presents as a small ulcer, plaques, papulonodular lesion to cauliflower-like warty masses and cicatricial forms. The disease is relatively uncommon, with only a few published case report.

METHODS: A 35-year-old female presented with phagedenic ulcer on the face since 15 years. Examination identified a plaque with central perforation on the right side of the face with crusting and oozing and a scar at the periphery with visible underlying turbinates. A biopsy was done and sent for histopathologic examination and culture. Treatment was started with oral fluconazole, 150 mg daily orally, suspecting subcutaneous fungal infection.

RESULTS: Biopsy revealed branched, septate, brown-colored dematiaceous hypae in the dermis indicating chromoblastomycosis. Fungal culture revealed Fonsecaea pedrosoi. Patient responded well to treatment, and still she is on treatment.

CONCLUSIONS: We believe that this is the first case report of chromoblastomycosis presenting as phagedenic ulcer.