PMC9761327_01
Clinical image of chromoblastomycosis infection of the jawline. Initial presentation of an excoriated papule on the right jawline. Enlarged crateriform nodule at the same site of the initial lesion 8 months later.
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The patient first noticed a small, round, and excoriated pink papule 8 months prior (Fig 1). Differential diagnosis included keratoacanthoma; squamous cell, Merkel cell, and metastatic carcinomas; prurigo nodule; molluscum contagiosum; and deep fungal infection (Fig 1).
Histopathology of shave biopsy. A, Pseudoepitheliomatous hyperplasia with suppurative collections of neutrophils and fungal organisms. B, Melanized fungal structures and thick-walled sclerotic cells (medlar bodies) consistent with the diagnosis of chromoblastomycosis (A, Hematoxylin-eosin stain; B, Gomori methenamine silver stain; original magnifications: A, x20; B, x20.)
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A shave biopsy was performed, the results of which revealed pseudoepitheliomatous hyperplasia with suppurative collections of neutrophils and fungal organisms suggestive of a deep fungal infection (Fig 2, A).