Combination Treatment of Itraconazole and Terbinafine for Chromoblastomycosis Caused by Fonsecaea pedrosoi

Abstract

Chromoblastomycosis is a chronic subcutaneous fungal infection mainly caused by Fonsecaea pedrosoi. This report describes a 42-year-old man with a verrucous plaque on the right ankle, initially presenting as small papules ten years ago, progressively enlarging. The patient, an oil palm worker, had a history of recurrent trauma and inadequate antifungal treatment. Diagnosis was confirmed by KOH, histopathology, and culture showing Fonsecaea pedrosoi. Combination therapy with itraconazole 100 mg twice daily and terbinafine 250 mg once daily for six months led to complete clinical and mycological cure. This case emphasizes the role of combined antifungal therapy in neglected chromoblastomycosis and the importance of early diagnosis and adherence to treatment.