A Case of Skin Chromoblastomycosis Caused by Fonsecaea monophora Treated with Itraconazole and Photodynamic Therapy

• Chromoblastomycosis (CBM) caused by Fonsecaea monophora is a rare fungal infection with low cure rates and high recurrence. • Conventional treatment (e.g., oral itraconazole) can be insufficient, with high recurrence rates, highlighting the need for additional therapies. • Combining oral itraconazole with photodynamic therapy (PDT) proved highly effective in this case—leading to complete lesion resolution and no recurrence over one year. Chromoblastomycosis(CBM), particularly caused by Fonsecaea monophora, presents significant clinical challenges due to its difficulty in treatment and high recurrence rates, with no established gold standard for therapy. This case report highlights a successful treatment approach that addresses this challenging disease. We report a 65-year-old female patient with a one-year history of a skin lesion on the dorsum of her right hand, diagnosed with CBM through histopathological and mycological examinations. The patient was treated with oral itraconazole at a dosage of 200 mg daily, in conjunction with photodynamic therapy using 5-aminolevulinic acid photodynamic therapy (ALA-PDT), administered biweekly. After one month of ALA-PDT treatment, the patient showed marked improvement. Continued oral itraconazole for three months resulted in complete clinical resolution, with no recurrence observed during a one-year follow-up. The combination of ALA-PDT and antifungal treatment demonstrates an effective strategy for managing skin CBM caused by Fonsecaea monophora.