Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis

We present the case of an 80-year-old patient with a recurrent hyperpigmented and cauliflower-like skin tumor on the stump of his left index finger. Despite suggestive clinical appearance for chromoblastomycosis the tumor was initially clinically and also histopathologically misdiagnosed as recurren...

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Main Authors: B. Jakopp, B. Stamm, D. Eyer, A. Conen
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2013/450153
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author B. Jakopp
B. Stamm
D. Eyer
A. Conen
author_facet B. Jakopp
B. Stamm
D. Eyer
A. Conen
author_sort B. Jakopp
collection DOAJ
description We present the case of an 80-year-old patient with a recurrent hyperpigmented and cauliflower-like skin tumor on the stump of his left index finger. Despite suggestive clinical appearance for chromoblastomycosis the tumor was initially clinically and also histopathologically misdiagnosed as recurrent squamous cell carcinoma. Due to a cardiogenic shock, the patient died shortly after the diagnosis of chromoblastomycosis, before adequate treatment could be introduced. In non-tropical regions chromoblastomycosis is an uncommon chronic fungal infection with Fonsecaea pedrosoi being the most prevalent etiological agent. Mostly lower extremities are involved. It is not unusual that, clinically, in the absence of pigmentation, and, histopathologically, because of pseudoepitheliomatous hyperplasia of the epidermis, chromoblastomycosis is confounded with squamous cell cancer, and delays in diagnosis of one to 3 years are common. Therefore, a high grade of clinical suspicion and inclusion of chromoblastomycosis in the differential diagnosis of pigmented skin tumors are important to initiate adequate therapy. Our case is remarkable in many aspects. The localization on an upper extremity and the grade of invasiveness with involvement of bone are unusual; furthermore the lack of a tropical travel history emphasizes that the infection almost surely occurred in Switzerland.
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spelling doaj-art-c6ea58741fbf4c9584bec4479ac32cb72025-08-20T03:23:34ZengWileyCase Reports in Infectious Diseases2090-66252090-66332013-01-01201310.1155/2013/450153450153Hidden under a Cauliflower-Like Skin Tumor: ChromoblastomycosisB. Jakopp0B. Stamm1D. Eyer2A. Conen3Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031 Basel, SwitzerlandDepartment of Pathology, Kantonsspital Aarau, Tellstraße, 5000 Aarau, SwitzerlandDepartment of Plastic, Reconstructive and Aesthetic Surgery, Kantonsspital Aarau, Tellstraße, 5000 Aarau, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Kantonsspital Aarau, Tellstraße, 5000 Aarau, SwitzerlandWe present the case of an 80-year-old patient with a recurrent hyperpigmented and cauliflower-like skin tumor on the stump of his left index finger. Despite suggestive clinical appearance for chromoblastomycosis the tumor was initially clinically and also histopathologically misdiagnosed as recurrent squamous cell carcinoma. Due to a cardiogenic shock, the patient died shortly after the diagnosis of chromoblastomycosis, before adequate treatment could be introduced. In non-tropical regions chromoblastomycosis is an uncommon chronic fungal infection with Fonsecaea pedrosoi being the most prevalent etiological agent. Mostly lower extremities are involved. It is not unusual that, clinically, in the absence of pigmentation, and, histopathologically, because of pseudoepitheliomatous hyperplasia of the epidermis, chromoblastomycosis is confounded with squamous cell cancer, and delays in diagnosis of one to 3 years are common. Therefore, a high grade of clinical suspicion and inclusion of chromoblastomycosis in the differential diagnosis of pigmented skin tumors are important to initiate adequate therapy. Our case is remarkable in many aspects. The localization on an upper extremity and the grade of invasiveness with involvement of bone are unusual; furthermore the lack of a tropical travel history emphasizes that the infection almost surely occurred in Switzerland.http://dx.doi.org/10.1155/2013/450153
spellingShingle B. Jakopp
B. Stamm
D. Eyer
A. Conen
Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis
Case Reports in Infectious Diseases
title Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis
title_full Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis
title_fullStr Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis
title_full_unstemmed Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis
title_short Hidden under a Cauliflower-Like Skin Tumor: Chromoblastomycosis
title_sort hidden under a cauliflower like skin tumor chromoblastomycosis
url http://dx.doi.org/10.1155/2013/450153
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