Malignant Transformation under Long-standing Chromomycosis Lesion

Chromomycosis is a chronic granulomatous dermatosis, characterized by verrucous and nodular cutaneous lesions, caused by various dematiaceous fungi, primarily of the genus Fonsecaea or Cladophialophora. The disease affects men aged 40 to 50 in tropical and subtropical regions, including South America. Currently, chromomycosis is considered a neglected tropical disease and is not included in the list of notifiable diseases, complicating the accurate assessment of its incidence and prevalence in the Brazilian population. However, it is known that most cases are concentrated in the northern states of the country. Diagnosis can be made through direct mycological examination with 10-20% potassium hydroxide, visualizing medlar bodies. However, species identification requires tissue culture. Treatment is individualized, considering comorbidities, patient tolerance and adherence, lesion size, and histopathological characteristics, presenting a challenge due to the recalcitrant nature of the disease, especially in severe clinical forms