A case report of cutaneous leishmaniasis: a misleading clinical presentation
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CASE REPORT
A case report of cutaneous leishmaniasis: a misleading clinical presentation Corentine Vanlier1 · Liliane Marot1,2 · Eva Laranaga3 · Philippe D’abadie4 · Jean‑Cyr Yombi3 · Halil Yildiz3 · Marie Baeck1 Received: 11 June 2020 / Accepted: 25 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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 Leishmaniasis · Skin · Leishmania infantum
Introduction Cutaneous leishmaniasis (CL) is a parasitic disease transmitted by sand fly bite and the incidence of which has been increasing in recent years [1]. In Europe, CL is frequently unrecognized and late diagnosed because of unfamiliarity by physicians due to its wide variety of clinical manifestations and its non-specific histology [2]. With histology the diagnosis is often overlooked and even with a specific histology * Marie Baeck [email protected] 1
Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
2
Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
3
Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
4
Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
picture, the Giemsa stain in it, misses in many cases the parasite, unless PCR is done. The incubation period of old world CL can be long (1 week to 1 year or more [3]), which also contributes to a frequent delay in diagnosis [2]. Moreover, this parasite is responsible for chronic skin lesions that can heal spontaneously.
Case description An otherwise healthy 67-year-old man presented to the dermatology outpatient clinic at the Cliniques universitaires SaintLuc, Brussels, Belgium, with a 7-year history of inflammatory lesions of the scalp and face. The patient lived in Belgium, but was of Italian origin and regularly travelled to the province of Molise in southern Italy
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