Chromoblastomycosis: tissue modifications during itraconazole treatment.

Background:: Histological and mycological changes during itraconazole use have not been totally established in chromoblastomycosis.

Objectives:: To evaluate tissue modifications in chromoblastomycosis carriers under itraconazole treatment.

Methods:: A histological retrospective study of 20 cases of chromoblastomycosis seen at the university hospital at the south of Brazil, during itraconazole 400 mg daily treatment. Patients were classified into two groups: plaque or tumor lesions, and underwent periodic evaluations every four months during three years. Hematoxylin-eosin stain was used to analyze epidermal modifications, inflammatory infiltrate and fibrosis, and Fontana-Masson stain for parasite evaluation.

Results:: Fontana-Masson stain was superior to hematoxylin-eosin stain in fungal count in the epidermis (mean difference=0.14; p<0.05). The most distinct mycosis tissue responses were registered in the dermis. Epidermal thinning, granulomatous infiltrate decrease or disappearance, fibrosis increase and quantitative/morphological changes occurred during treatment.

Study limitations:: Patients could not be located to have their current skin condition examined.

Conclusion:: Parasitic and tissue changes verified in this study can reflect the parasite-host dynamics under itraconazole action.