Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin
Chromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause granulomatous and suppurative dermatosis. This infection is difficult to treat and there are limited therapeutic options, including terbinafine, itraconazole, and tioconazol...
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MDPI AG
2023-11-01
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| Series: | Diseases |
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| Online Access: | https://www.mdpi.com/2079-9721/11/4/162 |
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| author | Walter Belda Luiz Felipe Domingues Passero Caroline Heleno Chagas de Carvalho Paula Celeste Rubiano Mojica Pablo Andrade Vale |
| author_facet | Walter Belda Luiz Felipe Domingues Passero Caroline Heleno Chagas de Carvalho Paula Celeste Rubiano Mojica Pablo Andrade Vale |
| author_sort | Walter Belda |
| collection | DOAJ |
| description | Chromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause granulomatous and suppurative dermatosis. This infection is difficult to treat and there are limited therapeutic options, including terbinafine, itraconazole, and tioconazole. Classic treatment is administered for a long period of time, but some patients do not respond properly, and therefore, such therapeutic approaches possess low cure rates. Therefore, it is vital to develop new strategies for the treatment of CBM. In this regard, it has been observed that the association of immunomodulatory molecules such as glucan with therapy carried out with antifungal drugs improves cutaneous lesions in comparison to treatment with antifungal drugs alone, suggesting that drug association may be an interesting and significant approach to incorporate into CBM therapy. Thus, the aim of this work was to associate classical antifungal therapy with the adjuvants imiquimod and acitretin. In the present case, we reported a patient with extensive CBM caused by <i>Fonsaecae pedrosoi</i>, that affected an extensive area of the right leg, that was left without treatment for 11 years. He was treated with a classical combination of itraconazole and terbinafine via the oral route plus topical imiquimod and oral acitretin, as an adjuvant therapy. After five months of treatment, a significant regression of verrucous plaques was observed, suggesting that the use of these adjuvants combined with the classical antifungal drugs, intraconazole plus terbinafine, can reduce treatment time and rapidly improve the patient’s quality of life. This result confirms that the use of coadjuvant drugs may be effective in the treatment of this infectious disease. |
| first_indexed | 2024-03-08T20:50:20Z |
| format | Article |
| id | doaj.art-00549b617f8f4682ac047e5579885a2f |
| institution | Directory Open Access Journal |
| issn | 2079-9721 |
| language | English |
| last_indexed | 2024-03-08T20:50:20Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj.art-00549b617f8f4682ac047e5579885a2f2023-12-22T14:03:34ZengMDPI AGDiseases2079-97212023-11-0111416210.3390/diseases11040162Chromoblastomycosis: New Perspective on Adjuvant Treatment with AcitretinWalter Belda0Luiz Felipe Domingues Passero1Caroline Heleno Chagas de Carvalho2Paula Celeste Rubiano Mojica3Pablo Andrade Vale4Dermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, BrazilInstitute of Biosciences, São Paulo State University (UNESP), Sao Vicente 11330-900, BrazilDermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, BrazilDermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, BrazilDermatology Department, Medical School, University of São Paulo, Sao Paulo 05403-000, BrazilChromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause granulomatous and suppurative dermatosis. This infection is difficult to treat and there are limited therapeutic options, including terbinafine, itraconazole, and tioconazole. Classic treatment is administered for a long period of time, but some patients do not respond properly, and therefore, such therapeutic approaches possess low cure rates. Therefore, it is vital to develop new strategies for the treatment of CBM. In this regard, it has been observed that the association of immunomodulatory molecules such as glucan with therapy carried out with antifungal drugs improves cutaneous lesions in comparison to treatment with antifungal drugs alone, suggesting that drug association may be an interesting and significant approach to incorporate into CBM therapy. Thus, the aim of this work was to associate classical antifungal therapy with the adjuvants imiquimod and acitretin. In the present case, we reported a patient with extensive CBM caused by <i>Fonsaecae pedrosoi</i>, that affected an extensive area of the right leg, that was left without treatment for 11 years. He was treated with a classical combination of itraconazole and terbinafine via the oral route plus topical imiquimod and oral acitretin, as an adjuvant therapy. After five months of treatment, a significant regression of verrucous plaques was observed, suggesting that the use of these adjuvants combined with the classical antifungal drugs, intraconazole plus terbinafine, can reduce treatment time and rapidly improve the patient’s quality of life. This result confirms that the use of coadjuvant drugs may be effective in the treatment of this infectious disease.https://www.mdpi.com/2079-9721/11/4/162chromoblastomycosistreatmentacitretinimiquimod |
| spellingShingle | Walter Belda Luiz Felipe Domingues Passero Caroline Heleno Chagas de Carvalho Paula Celeste Rubiano Mojica Pablo Andrade Vale Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin Diseases chromoblastomycosis treatment acitretin imiquimod |
| title | Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin |
| title_full | Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin |
| title_fullStr | Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin |
| title_full_unstemmed | Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin |
| title_short | Chromoblastomycosis: New Perspective on Adjuvant Treatment with Acitretin |
| title_sort | chromoblastomycosis new perspective on adjuvant treatment with acitretin |
| topic | chromoblastomycosis treatment acitretin imiquimod |
| url | https://www.mdpi.com/2079-9721/11/4/162 |
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