An Atypical Presentation of Cutaneous Leishmaniasis

Cutaneous leishmaniasis is a parasitic infection characterized by a high clinical polymorphism. Unusual clinical aspects have been reported in immunodeficient patients or associated with particular parasite species. This is the case report of a 36-year-old man with a history of type 1 diabetes who p...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-03, Vol.14 (3), p.e22836
Main Authors: Chahboun, Fatimazahra, Eljazouly, Madiha, Alj, Maha, Chiheb, Soumiya
Format: Article
Language:English
Subjects:
Biopsy
Case reports
Dermatology
Diabetes
Infectious Disease
Parasitic diseases
Pathology
Polymorphism
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Summary:Cutaneous leishmaniasis is a parasitic infection characterized by a high clinical polymorphism. Unusual clinical aspects have been reported in immunodeficient patients or associated with particular parasite species. This is the case report of a 36-year-old man with a history of type 1 diabetes who presented with a verrous plaque on the dorsal aspect of the fourth finger of the left hand, which appeared six months after traveling to southern Morocco. It was a papulo-nodular verrucous lesion, and was nonpruritic and nonpainful, with a keratotic surface, which had been progressively increasing in volume. A skin biopsy was performed, which showed evidence of leishmaniasis bodies after specific staining (May-Grünwald Giemsa stain). The patient was treated for eight weeks with weekly intralesional injections of meglumine antimoniate (Glucantime) and touch-ups with trichloroacetic acid (TCA) 20%. The evolution was marked by a clear regression of the lesion after four months. Herein, we describe a particular clinical aspect of cutaneous leishmaniasis: the verrucous form. This is a rare presentation that suggests the role of factors related to parasite species and/or diabetes. The combination of TCA with meglumine antimonate is a promising treatment option.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.22836