Treatment responses in patients with chromoblastomycosis to itraconazole in Madagascar.

Abstract

INTRODUCTION Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue caused by several pigmented fungi. It is frequently found in tropical and subtropical areas like Madagascar. This study primarily discusses the effects of antifungal therapy while also describing the epidemiological, clinical, and pathological features of CBM in our patients. METHODS From March 2013 to January 2019, a descriptive prospective study on chromoblastomycosis patients was undertaken. The study included patients with CBM who had received antifungal treatment for at least 3 months. Itraconazole 200 mg was given to patients every day for more than 3 months. Results were assessed at the 6th and 12th months, and classified as improvement, cure, or failure. RESULTS 29 cases of chromoblastomycosis were included. The mean age of patients was 42.02 years. They primarily worked in rural areas. Infected men were more prevalent. At the end of the 12th month of itraconazole therapy, 3 patients presented major responses, 14 patients had minor responses to treatment, and 12 had been lost to follow up. The clinical response of CBM to treatment was correlated to the severity and the long course of CBM. When compared to CBM caused by Cladophialophora, CBM caused by Fonsecaea showed a greater clinical response. CONCLUSION These findings demonstrated that chromoblastomycosis lesions are recalcitrant and difficult to treat.