A case report and literature review of “Chiclero's ulcer”

Summary An 86-year-old man with history of travel to Guatemala presented with a 4-month history of an enlarging ulcerative lesion on his right ear. After several weeks of empiric treatment for otitis externa, histopathology, culture, and PCR analysis of a biopsy specimen confirmed the diagnosis of l...

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Bibliographic Details
Published in:Travel medicine and infectious disease 2012-09, Vol.10 (5), p.275-278
Main Authors: Blaylock, Jason M, Wortmann, Glenn W
Format: Article
Language:English
Subjects:
Aged, 80 and over
Chiclero's ulcer
Cutaneous leishmaniasis
Diagnosis, Differential
Family medical history
Guatemala
Histopathology
Historic buildings & sites
Humans
Infections
Infectious Disease
Insect bites
Leishmania mexicana
Leishmania mexicana - isolation & purification
Leishmaniasis, Cutaneous - diagnosis
Leishmaniasis, Cutaneous - parasitology
Lesions
Literature reviews
Male
Pain
Parasitic diseases
Skin - parasitology
Skin - pathology
Travel
Travel medicine
Ulcer - parasitology
Ulcer - pathology
Ulcers
Vector-borne diseases
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Summary:Summary An 86-year-old man with history of travel to Guatemala presented with a 4-month history of an enlarging ulcerative lesion on his right ear. After several weeks of empiric treatment for otitis externa, histopathology, culture, and PCR analysis of a biopsy specimen confirmed the diagnosis of localized cutaneous leishmaniasis secondary to Leishmania mexicana . Known as “Chiclero's ulcer” in southeast Mexico and Latin America, this unique presentation of cutaneous leishmaniasis is caused mainly by the L. mexicana complex. Infection results in a single ulcerative lesion, most commonly involving the ear pinna, without a tendency for cutaneous metastasis, lymphatic or mucosal involvement. The majority of cases of “Chiclero's ulcer” spontaneously re-epithelialize without treatment within 3–9 months. This patient's lesion completely resolved without therapy after 11 months. “Chiclero's ulcer” should be considered in the differential diagnosis of a patient presenting with a chronic ulcerative lesion and history of travel to an endemic area.
ISSN:1477-8939
1873-0442
DOI:10.1016/j.tmaid.2012.08.005