Journal of Vocational Health Studies

AN UNUSUAL CASE OF CHROMOBLASTOMYCOSIS DUE TO FONSECAEA PEDROSOI IN SOUTH KERALA FOLLOWING A LEECH BITE: A CASE REPORT

Background: Chromoblastomycosis is a chronic cutaneous and subcutaneous fungal infection caused by melanized or brown-pigmented fungi, most commonly Fonsecaea pedrosoi. Purpose: This case report describes an unusual instance of chromoblastomycosis caused by F. pedrosoi in a woman from South Kerala with a preceding history of a leech bite, highlighting the importance of combining clinical examination, histopathology, fungal culture, and molecular sequencing for accurate diagnosis and effective management of this rare and chronic fungal infection. Case: A 54-year-old housewife presented with a 3 × 2 cm erythematous plaque on the dorsal aspect of left hand at the site of anatomical snuffbox. She reported a history of leech bite four years back at the same site. Dark pigmented colonies were isolated on Sabouraud dextrose agar. Skin biopsy for histological analysis, revealed sclerotic bodies, and Sanger sequencing. The patient was treated with oral itraconazole for two months. Result: The diagnosis of chromoblastomycosis was confirmed through fungal culture, histopathological examination revealing sclerotic bodies, and Sanger sequencing identifying F. pedrosoi. The patient responded well to two months of oral itraconazole over two months, with no recurrence of lesions noted on follow-up. Conclusion: Accurate identification of chromoblastomycosis is crucial due to its resistance to treatment and varied clinical manifestations, which often lead to misdiagnosis. However, combining systemic antifungal therapy with physical and surgical modalities has been shown to improve outcomes such an atypical mode of transmission underscores the need for heightened clinical awareness, especially in endemic areas or among patients with unusual environmental exposures.

Clinical and Mycological Patterns of Dermatophyte Infections in Patients Attending a Tertiary Care

Background: Dermatophytosis is a common superficial fungal infection caused by dermatophytes of the genera Trichophyton, Microsporum, and Epidermophyton, affecting keratinized tissues such as skin, hair, and nails. Changing epidemiological trends and increasing chronicity necessitate regular evaluation of clinical and mycological patterns in tertiary care settings. Aim: To determine the clinical and mycological patterns of dermatophyte infections and to correlate clinical diagnosis with potassium hydroxide (KOH) microscopy and culture findings among patients attending a tertiary care center. Methodology: This hospital-based descriptive observational study included 134 clinically diagnosed cases of dermatophytosis over one year. Detailed clinical evaluation was performed, and specimens were subjected to KOH mount and fungal culture on Sabouraud’s dextrose agar. Species identification was based on colony morphology and lactophenol cotton blue mount findings. Results: The majority of cases occurred in the 11–20 and 21–30 year age groups. Tinea corporis was the most common presentation, followed by tinea cruris, with annular morphology predominating. More than half of the cases were both KOH and culture positive. Among 82 culture-positive isolates, Trichophyton mentagrophytes was the predominant species, followed by Trichophyton rubrum. Conclusion: Dermatophytosis predominantly affects young individuals, with tinea corporis as the leading clinical form. Combined clinical and mycological evaluation enhances diagnostic accuracy, and Trichophyton species remain the principal etiological agents in this setting.

A Rare Case of Bilateral Facial Chromoblastomycosis Caused by Exophiala jeanselmei in an Immunocompetent Host: A Case Report

Assessment of Dermoscopic Characteristics of Molluscum Contagiosum: A Cross-sectional Study

Introduction: Molluscum Contagiosum (MC) is a cutaneous viral infection caused by molluscipoxvirus, affecting children, sexually active adults and immunosuppressed individual. Although it is easily diagnosed clinically, it can be confused with other clinical entities. In addition, the diagnosis becomes difficult when it has a single lesion or associated with inflammation. Thus, dermoscopy which is a non invasive and inexpensive tool helps to determine the diagnosis of MC. Aim: To evaluate the dermoscopic characteristics of MC and compare them with clinical presentation. Materials and Methods: The present cross-sectional observational study was conducted at the Outpatient Department (OPD) in the department of Dermatology, Venereology and Leprosy at a tertiary care center at a Grant Government Medical College, Mumbai, Maharashtra, India, for a period of 6 months from July 2025 to December 2025. Patients presenting with pearly white umbilicated papules and clinically suggestive of MC were included in the study. The patients’ history was recorded and examination done thoroughly and data such as the gender and age of the patient, the size of the lesions, the presence or absence of an orifice, vessels, inflammation and/or excoriation and perilesional eczema were recorded. A total of 33 patients with 161 lesions were included in the study. Dermoscopy was performed in 161 lesions from 33 patients where non vascular and vascular structures were noted in each lesion. Results were expressed in terms of frequency and percentage. Descriptive statistical analysis was done using IBM Statistical Package for the Social Sciences (SPSS) Statistics version 17.0. Results: A total of 33 patients with 161 lesions were included in the study. Of the 33 patients, 20 were males and 13 were females with mean age of 14.45±9.32 (range from 2 years to 32 years). The MC lesions were most frequently found on the face, trunk and upper extremities. The structures evaluated on dermoscopy included non vascular structures (whitish or yellowish structure) and vascular structures (crown, punctate, radial). On clinical and dermoscopy examination of 161 lesions, orifices were visualised in 100 and 161 of the lesions, and vessels in four and 72, respectively. The vascular patterns found in the 72 lesions on dermoscopy were the crown (23.60%), radial (11.18%) and punctiform patterns (9.93%). Conclusion: The dermoscopic findings of MC were non vascular and vascular. Rounded structures were common (70.80%) in the non vascular structure. Crown vessels (23.60%) were the most common vascular pattern observed; however, no vascular structures were seen in 55.28% of the lesions. Dermoscopy in lesions of MC was found to be superior as compared to clinical examination and aids in diagnosis of unusual presentations of these lesions.

Onychomycosis Caused by Kodamaea ohmeri in a Patient with Human Immunodeficiency Virus (HIV) – A Case Report

Cutaneous Protothecosis Associated with Long-Term Topical Corticosteroid: Clinicopathological Diagnostic Pointers

Cutaneous protothecosis is a rare opportunistic infection caused by achlorophyllous algae of the genus Prototheca and often poses a diagnostic challenge because of marked clinical polymorphism and the absence of pathognomonic features. We report a case of cutaneous protothecosis in a 78-year-old woman with a long history of pruritic skin eruptions and a history of uncontrolled long-term use of topical corticosteroids. During prior evaluation, systemic connective tissue disease and a paraneoplastic etiology of the cutaneous process were excluded. The key diagnostic step was a skin biopsy with histopathological examination, which demonstrated a lichenoid pattern combined with productive granulomatous inflammation in the dermis, raising suspicion of an infectious dermatosis and prompting additional special stains. Ziehl–Neelsen staining was negative, excluding mycobacterial infection. Periodic acid–Schiff (PAS) staining revealed PAS-positive structures. Culture of shave-biopsy material on Sabouraud dextrose agar yielded Prototheca wickerhamii, confirming the diagnosis of protothecosis. The patient was started on itraconazole 100 mg twice daily, with gradual regression of skin lesions and improvement of subjective symptoms.