Unusual Presentations of Cutaneous Leishmaniasis in an Endemic Area, Kerman Province, Iran

Document Type: Case Report

Authors

1 Professor of Dermatology, Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran

2 Assistant Professor of Dermatology, Department of Dermatology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

3 Resident of Dermatology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Leishmaniasis is a infectious disease with broad spectrum of clinical features from typical noduloulcerative lesion to atypical lesions. In this article, we presented 4 cases with atypical presentation of cutaneous leishmaniasis lesions (including eczematous, sporotrichoid and lichenoid) in an endemic area in Iran, Kerman. The first case was a 28- year- old man presented with a pruritic purplish -red plaque with lichenoid appearance around proximal nail fold of right third finger since a few months ago. The second case was a young woman with an indurated yellowish-brown plaque with peripheral depigmentation firstly diagnosed as keloid with subsequent intralesional triamcinolone injection. The third case was a middle-aged woman with multiple ulcerated reddish-brown nodules and plaques in a linear array on both legs and one forearm (sporotrichoid pattern). The forth case was a man with a painful indurated reddish-brown plaque with yellowish crust and swelling resembling infected contact dermatitis.

Keywords


  1. Bailey MS, Lockwood DN. Cutaneous leishmaniasis. Clin Dermatol 2007; 25(2):203-11.
  2. Grevelink SA, Lerner EA. Leishmaniasis. Journal of the American Academy of Dermatology 1996; 34(2 Pt 1):257-72.
  3. Wolff K, Johnson RA, Saavedra D. Color Atlas & Synopsis of Clinical Dermatology. 7th ed. NewYork: McGraw-Hill; 2013.
  4. Bienzle U, Ebert F, Dietrich M. Cutaneous leishmaniasis in Eastern Saudi Arabia. Epidemiological and clinical features in a nonimmune population living in an endemic area. Tropenmed Parasitol 1978; 29(2):188-93.
  5. Momeni A, Aminjavaheri M. Clinical picture of cutaneous leishmaniasis in Isfahan, Iran. International Journal of Dermatology 1994; 33(4):260-5.
  6. Karincaoglu Y, Esrefoglu M, Ozcan H. Atypical clinical form of cutaneous leishmaniasis: erysipeloid form. International Journal of Dermatology 2004; 43(11): 827–9.
  7. Rubio F, Robayna G, Heranz P, Torres E, Peña J, Contreras F, et al. Leishmaniasis presenting as a psoriasiform eruption in AIDS. British Journal of Dermatology 1997; 136(5): 792–4.
  8. El-Hoshy K. Lip leishmaniasis. Journal of the American Academy of Dermatology 1993; 28(4):661-2.
  9. Raja KM, Khan AA, Hameed A, Rahman SB. Unusual clinical variants of cutaneous leishmaniasis in Pakistan. Br J Dermatol 1998; 139(1):111-3.
  10. Akilov OE, Khachemoune A, Hasan T. Clinical manifestations and classification of Old World cutaneous leishmaniasis. Int J Dermatol 2007; 46(2):132-42.
  11. Moravvej H, Barzegar M, Nasiri S, Abolhasani E, Mohebali M. Cutaneous leishmaniasis with unusual clinical and histological presentation: report of four cases. Acta Medica Iranica 2013; 51(4):274-8.
  12. Ghorbani GH, Hosseini SJ, Pourfarziani V, Ameli J, Akbari MH. Cutaneous leishmaniasis before and after renal transplantation; a case report. Iranian Journal of Clinical Infectious Diseases 2007; 2(1):33-6.
  13. Ayatollahi J. Sporotrichoid cutaneous leishmaniasis in central Iran. Iran J Med Sci 2006; 31(3): 173-5.
  14. Tobin EH, Jih WW. Sporotrichoid lymphocutaneous infections: etiology, diagnosis and therapy. Am Fam Physician 2001; 63(2):326-32.
  15. Cozzani E, Satta R, Fausti V, Cottoni F, Parodi A. Cutaneous sporotrichoid leishmaniasis resistant to pentavalent antimonial therapy: complete resolution with itraconazole. Clin Exp Dermatol 2011; 36(1):49-51.
  16. Morelli P, Gianelli E, Calattini S, Corbellino M, Antinori S, Meroni L. Itraconazole can be effective in the treatment of sporotrichoid leishmaniasis. Journal of Travel Medicine 2004; 11(5):328-30.
  17. Marovich MA, Lira R, Shepard M, Fuchs GH, Kruetzer R, Nutman TB, et al. Leishmaniasis recidivans recurrence after 43 years: a clinical and immunologic report after successful treatment. Clin Infect Dis 2001; 33(7):1076-9.
  18. Nasiri S, Robati RM, Marefat A, Saeedi M, Sarrafi-rad N. Bilateral cutaneous leishmaniasis presenting as eczema-like eruptions on the hands. Indian J Dermatol Venereol Leprol 2010; 76(3):307.
  19. Ayatollahi J, Bafghi AF, Shahcheraghi SH. Rare variants of cutaneous leishmaniasis presenting as eczematous lesions. Med J Islam Repub Iran 2014; 28: 71.
  20. Chaabane H, Turki H. Cutaneous Leishmaniasis with a Paronychia-like Lesion. N Engl J Med 2014; 371:1736.
  21. Mahmood K. An unusual paronychia. Clinical and Experimental Dermatology 2007; 32(5):611-2.