CHROMOBLASTOMYCOSIS IN THE BRAZILIAN AMAZON: A NARRATIVE REVIEW ON EPIDEMIOLOGY, DIAGNOSIS, AND TREATMENT (2020-2025)

Abstract

Chromoblastomycosis (CBM) is a chronic, granulomatous subcutaneous mycosis caused by the traumatic implantation of melanized fungi, with Fonsecaea pedrosoi being the predominant etiological agent in Brazil. The country is considered one of the main global epicenters of the disease, with high endemicity in the Amazon region, especially in the state of Pará. The objective of this study was to conduct a narrative literature review on the morphophysiological, epidemiological, pathogenic, and therapeutic aspects of CBM. The methodology involved the analysis of databases such as PubMed, SciELO, and CAPES, with an emphasis on recent publications (2020-2025). The results highlight that fungal virulence is linked to melanin production and the transition to muriform cells, structures highly resistant to the immune response. The gold standard diagnosis remains direct mycological examination for the visualization of sclerotic bodies, while molecular and proteomic techniques (MALDI-TOF MS) emerge as crucial tools for differentiating cryptic species. In the therapeutic scope, Itraconazole and Terbinafine are the drugs of choice, often associated with physical methods. It is concluded that, due to high recurrence rates and disabling social impact, CBM must be prioritized in public health policies, with an urgent need for investment in new biotechnological and phytotherapeutic approaches for the management of this neglected disease.