Longitudinal melanonychia secondary to chromoblastomycosis due to Fonsecaea pedrosoi
Sarti, H.M.; Vega-Memije, M.ía.E.; Domínguez-Cherit, J.; Arenas, R.
International Journal of Dermatology 47(7): 764-765
2008
ISSN/ISBN: 1365-4632 PMID: 18613892 DOI: 10.1111/j.1365-4632.2008.03494.x
Accession: 032196446
A 68-year-old man from the northern state of Tamaulipas, Mexico presented with a disseminated dermatosis involving the left side of the face, left arm, and hand. He had multiple verrucous plaques. Chromoblastomycosis was confirmed by the presence of sclerotic cells in KOH and Fonsecaea pedrosoi when later isolated in culture. He was treated irregularly with multiple oral antifungal drugs with no response prior to consultation. One year later, a black irregular macule appeared on the left cheek, and the biopsy showed a malignant melanoma in situ. The patient also had a history of a squamous cell carcinoma on the verrucous plaque, on the left elbow, which was removed surgically. A longitudinal 3 mm-wide melanonychia was found affecting the nail of the index finger. Direct exam showed the presence of atypical sclerotic cells underneath the nail. The diagnosis was subunguial chromoblastomycosis. Malignant neoplasms have been rarely reported in association with chromoblastomycosis. This patient with disseminated chromoblastomycosis had two different malignancies on the skin with chronic fungal infection. The authors did not find cases of onychomycosis caused by F. pedrosoi in the literature.
