Chromoblastomycosis is curable with DAT therapy (debulking, intralesional amphotericin B, oral terbinafine); case series of 16 patients.

Abstract

Abstract: Once incurable and chronic devastating diseases of chromomycosis is now curable with, debulking, intralesional amphotericin B and oral terbinafine (DAT). Debulking methods ranged from electrocautery to total surgical excision according to the size and the site of the lesion; a diluted solution of 1 mg/mL of amphotericin B (AMB) was injected weekly at the edge of the lesion; and simultaneous treatment with daily 500 mg oral terbinafine. Voriconazole 200 mg twice daily was added in one patient who had infection spread along the right lower limb for more than 20 years. DAT therapy was continued until complete clinical clearance where 14 out of 16 (87.5%) were cured using intralesional AMB 4-8 weeks (mean 5.8, mode 7) and oral terbinafine 6-12 weeks (mean 9.6, mode 12). Two patients who had lesions for 10 years and 20 years had to continue treatments for 14 weeks and 34 weeks, respectively, leaving scarring, chronic lymphedema, or depigmentation to a lesser degree. Early initiation of treatment gives an optimal outcome in a shorter period of time without residual sequelae.