A case report of cutaneous leishmaniasis: a misleading clinical presentation

Infection. 2021 Feb;49(1):177-180. doi: 10.1007/s15010-020-01517-1. Epub 2020 Sep 2.

Abstract

Background: The diagnosis of cutaneous leishmaniasis (CL) is often difficult because of the diversity of clinical presentations, its often-misleading appearance and the very long incubation period (time between the endemic stay and the onset of skin lesions).

Case: We report the case of an otherwise healthy 67-year-old man who presented with inflammatory skin lesions on the scalp and face for the past 7 years. The lesions were first mistaken as cutaneous sarcoidosis, mycobacterial infection, and cutaneous lymphoma. Finally, the diagnosis was made by RT-PCR analysis on a punch-biopsy specimen, which was positive for Leishmania infantum. DISCUSSION AND CONCLUSION: To date, the choice of treatment for complex cutaneous leishmaniases is based on the Leishmania species. Our patient successfully responded to liposomal amphotericin B.

Keywords: Leishmania infantum; Leishmaniasis; Skin.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use
  • Antiprotozoal Agents / therapeutic use
  • Biopsy
  • Diagnosis, Differential
  • Face / parasitology
  • Face / pathology
  • Humans
  • Leishmania infantum / genetics
  • Leishmania infantum / isolation & purification
  • Leishmaniasis, Cutaneous* / diagnosis
  • Leishmaniasis, Cutaneous* / drug therapy
  • Leishmaniasis, Cutaneous* / parasitology
  • Leishmaniasis, Cutaneous* / pathology
  • Male
  • Scalp / parasitology
  • Scalp / pathology
  • Skin / parasitology
  • Skin / pathology

Substances

  • Antiprotozoal Agents
  • liposomal amphotericin B
  • Amphotericin B