Occupational chromomycosis in an açaí picker: a case report in the Amazon region

Abstract

Objective: To describe a case of chromoblastomycosis in an açaí picker in the Amazon region. Case details: A 41-year-old male patient complained of a chronic verrucous lesion on the medial dorsum of his left foot, associated with pain, pruritus, and edema. His occupation is açaí harvesting, using a traditional peconha (a type of hand-held stingless stick) as a tool, a factor possibly related to inoculation of the etiological agent. Physical examination revealed a well-defined, erythematous, crusted plaque with ulcerated, verrucous-like areas measuring approximately 5 cm. Dermoscopy revealed black dots, scales, peripheral erythema, and signs of fibrosis. Direct mycological examination revealed muriform cells consistent with chromoblastomycosis. Treatment included itraconazole and cryotherapy, with favorable clinical outcome. Final considerations: This case highlights the relationship between occupational factors and the development of chronic subcutaneous mycoses. The clinical, dermoscopic, and histopathological descriptions, combined with the therapeutic response, contribute to expanding knowledge about effective management of the disease, which is underreported and neglected in endemic areas. Finally, the case highlights the importance of dermatological surveillance in populations exposed to environmental risks, such as extractivists and farmers, to promote early diagnosis and the adoption of appropriate prevention and treatment measures.