Chromomycosis Treatment With Combination Of Itraconazole And Terbinafine
ABSTRACT: Chromomycosis is a
localized chronic mycosis of skin and subcutaneous tissue caused by pigmented
fungi. It is most common in tropical regions. Lesion usually presented with
trauma history, and characterized by nodular verrucous that grow slowly on the
lower extremities. The disease is difficult to treat. Case Report: A
33-year-old male garderner came with the main complaint multiple bumps
accompanied with itchy and pain sensation on left leg that has became wider since
15 years before. There was a history of a thorn trauma in his left lower
extrimity and he used to contact with soil and plants. The patient was
diagnosed as chromomycosis based on history, clinical features, and confirmed
with potassium hydroxide 10% that showed muriform cell, and fungal culture
revealed the species Fonsacaea pedrosoi. The patient has not improved
significantly treated with ketoconazole 200 mg 2 times daily for 9 months. The
treatment was replaced into itrakonazole 100 mg 2 x 2 tablets combined with
terbinafine 250 mg 2 x 1 tablets for 7 months and it gave a good result. Discussion:
Predisposing factors in this case were a history of thorn trauma and contact
with soil and plants continously. The lesions improved after 7 months treated
with itraconazole and terbinafine. Chromomycosis is very difficult to treat and
until now the gold standard treatment is not available yet. Combination
therapy, itraconazole and terbinafine, could be considered for the therapy of
chromomycosis with good result. Combination therapy can be continued until 2-4
weeks after no palpable nodules anymore.
Key words: chromomycosis,
Fonsacaea pedrosoi, itrakonazole, terbinafine
Penulis: Amalia Rositawati,
Sunarso Suyoso
Kode Jurnal: jpkedokterandd170495
