A case of chromomycosis successfully treated with topical hyperthermia.
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We report a 68-year-old man with chromomycosis successfully treated with topical hyperthermia. He had been suffering for ten years from a skin lesion on his upper right arm. When he visited our clinic, the skin lesion was an annular erythematous plaque with scales, measuring 7×11cm2. A potassium hydroxide preparation of the scales revealed several sclerotic cells. Fonecaea pedrosoi was isolated from both the scales and biopsy specimen. The patient was treated with topical hyperthermia using a pocket warmer for 12 hours a day. During the treatment, the temperature of the dermis was maintained at 39°C. The lesion healed in about five weeks. The ioslated fungus did not grow at either 39°C or 41°C. However, when cultured for 12 hours at 39°C and 12 hours at room temperature everyday, it grew to 80% of the size of a culture at room temperature. A histopathological study showed that the number of neutrophils in the dermis decreased immediately after the therapy. The lymphocytes, plasma cells, histiocytes, and foreign body giant cells gradually increased in number. These results suggest that the efficacy of hyperthermia in chromomycosis is not only its direct effect on fungi, but the activation of cell-mediated immunity, consequent enhancement of granulomatous reaction, and the activation of humoral immunity.
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