Chromoblastomycosis in sub-tropical regions of India.

Chromoblastomycosis is a chronic fungal infection caused by several pigmented fungi commonly seen in tropical and sub-tropical climate. We report here two cases of chromoblastomycosis from the tea gardens of Assam, a state in the north-eastern region of India having a subtropical climate. Of the two patients, one presented with extensive lesions covering a large area of the body and gave a past history of thorn prick in his right foot. The laboratory diagnosis was done by direct microscopy and culture of skin scraping and biopsy tissue and the isolate was identified as Cladophialophora carrionii. On contrary to the fact that Chromoblastomycosis is known for its slow spread and chronic nature, a rapid spread of the disease within a short span of 8 months was noticed in this case affecting the livelihood of the patient. To best of our knowledge, this is the first report of chromoblastomycosis caused by Cladophialophora carrionii from Assam. In the second patient, a large cauliflower like mass in the leg was the presenting feature. Diagnosis was confirmed by microscopy and culture of the biopsy tissue. Fonsecaea pedrosoi was isolated from this case. Both the patients were treated with Fluconazole and showed slight improvement with decrease in size of the lesions after 1 month.