A Case of Skin Chromoblastomycosis Caused by Fonsecaea monophora Treated with Itraconazole and Photodynamic Therapy

Chromoblastomycosis, particularly caused by Fonsecaea monophora, presents significant clinical challenges due to its difficulty in treatment and high recurrence rates, with no established gold standard for therapy. This case report highlights a successful treatment approach that addresses this pressing issue. We report a 65-year-old female patient with a one-year history of a skin lesion on the dorsum of her right hand, diagnosed with chromoblastomycosis through histopathological and mycological examinations. The patient was treated with oral itraconazole at a dosage of 200 mg daily, in conjunction with photodynamic therapy using 5-aminolevulinic acid photodynamic therapy (ALA-PDT), administered biweekly. After one month of ALA-PDT treatment, the patient showed marked improvement. Continued oral itraconazole for three months resulted in complete clinical resolution, with no recurrence observed during a one-year follow-up. The combination of ALA-PDT and antifungal treatment demonstrates an effective strategy for managing skin chromoblastomycosis caused by Fonsecaea monophora.