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Diagnosis of chromoblastomycosis is often delayed for multiply reasons; poor degree of clinical suspicion or confusion with similar condition due to its polymorphic features and difficulties of confirmed laboratory examination. The case series aims for describing clinical appearance and mycological examination variation of chromoblastomycosis. We reported four cases of chromoblastomycosis with different type of clinical appearance. Each case appeared with different morphology; verrucous-type, tumor-type, plaque-type and mixed type. All patient had history of contact with soil, multiple trauma and chronic course of disease. Diagnosis of chromoblastomycosis in all cases were confirmed by finding sclerotic bodies in either potassium hydroxide or histopathology examination, the fungal of culture of all cases are suitable of the growth of Fonsecaea pedrosoi. All cases were treated by pulse dose itraconazole 400mg daily for a week every month. Chromoblastomycosis is fungal infection caused by pigmented fungi acquired usually by inoculation of the skin as part of occupational or environmental hazards. It is found in immunocompetent host; all cases had no history of comorbidity. As the verrucous-type is the common type, chromoblastomycosis often misdoubt with tuberculosis cutis verrucose, as like our first case. Microscopic detection of sclerotic bodies is important and four cases here confirmed the diagnosis by its finding. Fonsecaea pedrosoi is the most common cause of chromoblastomycosis, detected in the first three cases. Itraconazole and terbinafine are the choice anti-fungal either pulse dose or daily dose. [ABSTRACT FROM AUTHOR]

Background: One of the indicators of achieved leprosy control is lower new cases of leprosy with grade 2 disability (G2D), while zero new pediatric case with G2D is one of the targets of The Global Leprosy Strategy. This study aimed to describe the characteristics of leprosy in children with G2D from seven provincial hospitals in Indonesia, spanning a period of five years. Methods: This was a descriptive and retrospective study with cross-sectional design. Data were obtained from the medical records of leprosy-affected children in seven provincial hospitals in Indonesia between January 2014 and December 2019 using a total sampling method. Data obtained include characteristics of patients, clinical manifestations, and profile of leprosy in children with G2D. Results: From the 132 data of childhood leprosy retrieved, male (58.33%), age group of 13– 14 years (47.73%), and borderline tuberculoid leprosy (34.09%) comprised the majority of patients. Most of the patients had anesthetic macules as the initial manifestation. The results showed 20 (15.15%) children had G2D. Hands were the most common site affected (50.00%), manifested as claw hands, contractures, atrophy of thenar and hypothenar muscles, and pseudomutilation. Foot drop was seen in five (62.50%) children, and lagophthalmos was seen in one child with leprosy. Conclusion: This study shows that G2D is observed in 15.15% Indonesian children with leprosy at the time of diagnosis, which mostly occurs on the hands in the form of claw hands. Foot disabilities were also observed, most commonly as foot drop, while lagophthalmos was present with disabilities in the eyes. Disability due to leprosy in children really exists. The commitment of all health care services and related institutions is needed in order to reduce the incidence of disability due to leprosy in children. [ABSTRACT FROM AUTHOR]