From Big Medical Encyclopedia

CHROMOMYCOSIS (chromomycosis;

Greek chroma color, coloring + mykes a mushroom 4--osis; synonym: chromoblasts

of goats, a tropical zymonematosis, a warty zymonematosis, a disease of Ped-Roseau, Lane's disease — A. Pedroso) — deep mycosis of skin and hypodermic cellulose, for to-rogo tendency to progressing and formation of verrukozny rashes is characteristic.

The disease was described for the first time by A. Pedroso in 1911 in Brazil.

Causative agents of chromomycosis are different types of fungi: in 1915 Medlar (E. M. Medlar) and Lane (Page G. Lane) independently from each other described a fungus of Phialophora verrucosa, E. Brumpt in 1922 — Hormodendrum pedrosoi, A. L. Carrion in 1935 allocated a fungus of Hormodendrum compactum (see Fungi parasitic). These fungi saprofitirut in the soil and on plants. A fungus — dimorphous (has fabric — parasitic, or barmy and mitselialny forms). In fabrics single fungi or their accumulations are found. A fungus of rounded shape with a double-circuit cover (also threads sometimes meet) brownish or yellowish color. On Saburo's circle (see Saburo of the environment) at t ° 25 ° the colony grows on 4 — the 5th day in the form of a mouse gray hillock. The mycelium of a straight line branching chlamydospores are divided into 2 — 4

cells of 3 in size — 4 microns.

Chromomycosis meets in the countries with tropical and subtropical climate more often (in the countries of South America, Africa, and also in Australia, India); cases in the USA, Canada, Poland, the USSR are described.

Chromomycosis nekontagiozen, its epidemiology is not studied; only people are ill, men are more often.

Developing of chromomycosis is promoted by injuries of skin (splinters, cuts), and also a varicosity of the lower extremities, burns, etc. Infection is possible through upper respiratory tracts. Dissimination of a fungus in an organism occurs in the lymphogenous way.

At gistol. a research of skin the picture hron is noted. an infectious granuloma (see) with subcorneal and intradermal microabscesses, in to-rykh characteristic spherical little bodies of the activator come to light. Microabscesses are surrounded with leukocytes, epithelial and colossal cells. The granuloma occupying all thickness of a derma consists of lymphocytes, plasmocytes, macrophages and a small amount of eosinophils and fibroblasts.

The incubation interval fluctuates from several weeks to several months. In the beginning there is an erythematic and squamous center which is clinically reminding plaques at psoriasis (see). In the subsequent one of three a wedge, forms of chromomycosis — papillomatous yaz-vennaya, grumous or knotty develops (gummous). The general condition of patients suffers a little. Localization of the centers of defeat at chromomycosis is various, but more often they are located on feet, shins, re-

with Fig. 1. Foot of the patient with chromomycosis (pas-lillomatozno-ulcer form): the center of defeat in a type of papillomatous growths with sites of an ulceration, sharp scalloped borders, smooth infiltrirovanny edge.

Fig. 2. Shin of the patient with chromomycosis (grumous form): the infiltrates with scalloped edges and a clear boundary formed of the merged hillocks

. — on brushes and forearms, usually asymmetrically. At a pas-pilloma'tozno-ulcer form the center with a diameter up to 10 — 18 cm of oval or oblong shape with sharp scalloped borders and smooth infiltrirovanny edge appears, and infiltrate goes beyond a hyperemia (fig. 1). The surface of the center is covered with crusts, after removal to-rykh ulcerations of different degree of manifestation with warty growths and a small amount of krovyanistognoyny separated come to light. Sometimes vyso-

that papillomatous growths reaches 1 cm (they can remind a cauliflower).

At a grumous form there is a small hillock of conical shape of cyanochroic-red color inclined to peripheral growth. In several months it becomes dark-brown, becomes covered by a crust, around it there are new hillocks merging in the general conglomerate with scalloped edge (fig. 2). Then hillocks razkhmyagcha-tsya, ulcerate, become covered by fleecy growths.

At a knotty (gummous) form in hypodermic cellulose nodes up to 5 cm and more, a dense consistence, located on dense infiltrate are formed. Skin of a tsianotichn over them. Nodes are softened with formation of the ulcers covered with crusts after which removal papillomatous growths are visible. The combination of all forms at one patient is sometimes possible (some researchers consider them not forms, but stages of one process).

The diagnosis is established on the basis by a wedge, pictures and confirm with detection of a fungus at a research of scales, crusts and separated from affected areas. Differential diagnosis is carried out with a tuberculosis cutis (see Tuberculosis to not pulmonary), tertiary syphilis (see), a skin leushmaniosis (see Leyshmanioza), a vegetans pyoderma (see), a sporotrichosis (see), zymonematoses (see).

Treatment is carried out by high doses of potassium iodides, sodium, spirit solution of iodine or 10% solution of sodium iodide, and also V. Mestno's Amphotericinum appoint 20% a pyro-gallic plaster, Gordeev's liquid, ointment of the following structure: salicylic to - you are 1 g, the benzoic to - you are the 2nd, are gray besieged 3 g, ergocalciferol 1800000 ME, vaseline and lanolin on 15 g.

The forecast for life usually favorable; the current is long, up to 30 and more years; in isolated cases at lymphogenous dissimination of a fungus the lethal outcome as a result of damage of a brain is possible.

Prevention is not developed.

Bibliography: To and sh to and P. N. N and Sh e to -

l and to about in N. D. Guide to a medical mycology, page 255, M., 1978; Leshchenko V. M. Laboratory diagnosis of fungus diseases, page 129, M., 1982;

Mittag H. u. KreyselH. W. KP-nik, Diagnostik und Therapie der Chromo-mykose, Mykosen, Bd 25, S. 413, 1982; PedrosoA. Gomes J. M. Quatro casos de dermatite verrucosa, produzida pela phialophora, Brasil-med., v. 24, p. 105, 1920; V about 1 1 u m D. I. Chromomycosis, Brit. J. Derm., v. 96, p. 454, 1977.

V. M. Leshchenko.