KASUS KROMOBLASTOMIKOSIS PADA SEORANG PEREMPUAN

Abstract

Abstract: Chromoblatomycosis is a chronic fungal infection in the skin and subcutaneus tissue caused by pigmented fungi. It occurs most in males in tropical and subtropical countries. The causal fungi were found isolated in woods, decomposed plants, and soil.  Early lesions manifest as papules that become hypertrophy plaques, and in years they develop to become hyperkeratotic masses. Chromoblastomycosis is difficult to treat. We reported a female of 37 years with lesions on the right foot for 20 years in the forms of plaques, papulonodules, multiple verrucous lesions. Lesions had hard consistency and were associated with erosion, crustae, and minimal pus. Several supporting tests were carried out. KOH 20% test resulted in sclerotic bodies; fungal culture revealed Fonsecaea pedrosoi; and histopathological examination showed chronic granulomatous inflamation. The patient was treated with itraconazole 2 x 200 mg daily, which was planned for 8-12 months. After 2 months of treatment, the lesions improved. Conclusion: Based on anamnesis, physical examination, KOH test, tissue culture, and histopathology examination, this case was diagnosed as chromoblatomycosis. Fonsecaea pedrosoi was found as the causative agent. Oral antimycotic itrakonazole 2 x 200 mg/day showed lesion improvement after 2 months of treatment. The patient will be evaluated until full treatment  has been achieved.

Keywords: chromoblastomycosis, Fonsecaea pedrosoi, itrakonazole

Abstrak: Kromoblastomikosis merupakan infeksi jamur kronis pada kulit dan jaringan subkutan, disebabkan jamur berpigmen, umumnya pada laki-laki, banyak ditemukan di daerah tropis/subtropis, terisolasi di lingkungan dari kayu, sisa tanaman, dan tanah. Lesi awal berupa papul yang membesar membentuk plak hipertrofi dalam beberapa tahun menjadi massa hiperkeratotik. Kromoblastomikosis sukar disembuhkan. Kami melaporkan seorang perempuan 37 tahun dengan lesi pada kaki kanan sejak 20 tahun lalu berupa plak, papulonodul, verukous multipel, konsistensi keras, disertai erosi, krusta, pus yang minimal. Pada pemeriksaan KOH 20% didapatkan badan sklerotik, pemeriksaan kultur jamur ditemukan Fonsecaea pedrosoi, histopatologis menunjukkan radang kronik granulomatik. Terapi itrakonazole 2x200 mg/hari akan diberikan selama 8–12 bulan. Setelah 2 bulan pengobatan terdapat perbaikan. Simpulan: Pada kasus ini, diagnosis kromoblastomikosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang berupa KOH, kultur jaringan, dan histopatologi. Hasil kultur menunjukkan Fonsecaea pedrosoi sebagai penyebab kromoblastomikosis. Pemberian antimikotik oral itrakonazole 2 x 200 mg/hari menunjukkan perbaikan setelah 2 bulan pengobatan. Evaluasi akan terus dilanjutkan sampai pengobatan selesai.

Kata kunci: kromoblastomikosis, Fonsecaea pedrosoi, itrakonazole