Abstract

Chromoblastomycosis (CBM) is a chronic fungal skin infection typically affecting individuals in tropical and subtropical regions, particularly agricultural workers. The disease arises from traumatic inoculation of dematiaceous fungi, such as Fonsecaea pedrosoi and Cladophialophora carrionii, found in soil and decaying vegetation. CBM often mimics other dermatoses, including cutaneous tuberculosis, resulting in diagnostic delays. This case series from Eastern India presents four atypical cases initially misdiagnosed and treated as lupus vulgaris due to overlapping clinical features. Re-evaluation with histopathology, KOH mounts, and fungal cultures confirmed CBM, highlighting pseudoepitheliomatous hyperplasia and the presence of Medlar bodies as diagnostic hallmarks. Treatment with oral itraconazole led to significant clinical improvement in all cases. The report emphasizes the importance of considering CBM in chronic, verrucous skin lesions, especially in TB-endemic areas, and underlines the role of early biopsy and mycological investigations for accurate diagnosis and management. Early intervention improves outcomes and limits complications.

Keywords

chromoblastomycosis, pseudoepitheliomatous hyperplasia, pruritic, discoid lupus erythematosus (DLE), lesions