European Journal of Molecular & Clinical Medicine

Abstract

Introduction: The diagnosis of chromoblastomycosis -- a rare, chronic deep fungal infection of the skin -- often eludes clinician. As a non-invasive tool, dermoscopy examination could effortlessly impart clues to help narrowing down its differential diagnoses. We demonstrate a case in which certain dermoscopic feature positively corresponded with histopathologic finding. Case: A 71-year-old farmer presented with red mass on the dorsal right hand over the past two years. A scaly erythematous plaque measuring 7 cm x 5 cm x 0.2 cm with excoriations, and black dots was observed. Dermoscopy showed reddish-black dots, yellowish-orange area, and pink-whitish area. Histopathology revealed dense neutrophilic infiltration, intraepidermal debris, and muriform bodies, consistent with chromoblastomycosis. Discussion: Chromoblastomycosis clinically mimics cutaneous tuberculosis, verruca vulgaris, and mycetoma, among others. Our case had shown that reddish-black dots were easily recognized under the dermoscope examination and deemed as important findings as they were correlated with muriform bodies. Such features enabled exclusion of differential diagnoses before submitting patient for biopsy, thus preventing overuse of elaborate procedures such as culture and PCR for mycobacterial infection. Conclusion: Dermoscopic features of reddish-black dots correlated well with muriform bodies on histopathological examination; their identification is important in suspected case of chromoblastomycosis.