Pathogenic Evidence of Chromoblastomycosis is Rapidly Detected by Reflectance Confocal Microscopy and Dermoscopy: A Case Report

A patient was suspected of having chromoblastomycosis based on clinical manifestations and the medical history of fishbone injury.A dermoscopy of the inferior portion of the lesion showed a few interwoven dark red spots. In vivo reflectance confocal microscopy, a well-defined circular hole in the epidermis, and luminous white spherical bodies inside round cells were observed. Histopathology showed chromoblastomycosis within multinucleate giant cells in the dermis. Dematiaceous hyphae were seen on the smears, and darkly pigmented colonies, identified as F. pedrosoi, grew on the culture media. The lesion improved after treatment with itraconazole, histopathology showed the oval brown septate spores of CBM was gone; direct microscopic examination, revealed no darkly pigmented colonies; Luminous white spherical bodies are inside round cells was disappwar and a hole in the epidermis disappear disappear, as seen in vivo reflectance confocal microscopy. In vivo reflectance of “blackish-red dots” by dermoscopy decreased, but collagen bundles increased.