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[Leishmaniasis with multiple cutaneous nodules].

N Stosiek1, C Bogdan, W Solbach

  • 1Dermatologische Universitätsklinik, Universität Erlangen.

Deutsche Medizinische Wochenschrift (1946)
|November 13, 1992
PubMed
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A man developed skin nodules after travel to Yugoslavia, diagnosed as leishmaniasis. Topical paromomycin successfully treated the cutaneous leishmaniasis lesions.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Parasitology

Background:

  • Leishmaniasis is a parasitic disease transmitted by sandflies, presenting various clinical forms.
  • Cutaneous leishmaniasis is the most common form, characterized by skin lesions.
  • Diagnosis can be challenging, especially in non-endemic areas.

Observation:

  • A previously healthy 48-year-old man developed multiple reddish-livid, firm cutaneous nodules on his extremities six weeks after returning from Yugoslavia.
  • Histopathology revealed a tuberculoid, plasma-rich inflammatory reaction.
  • Immunohistochemistry and Western blot confirmed the presence of Leishmania-associated antigens, characteristic of leishmaniasis.

Findings:

  • The patient presented with multiple cutaneous nodules consistent with leishmaniasis.

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  • Despite potential liver damage, systemic treatment was avoided.
  • Local treatment with paromomycin ointment resulted in complete healing of the nodules within three months without scarring.

    • Implications:

    • This case highlights the importance of considering leishmaniasis in travelers returning from endemic areas, even with atypical presentations.
    • Topical paromomycin can be an effective treatment for cutaneous leishmaniasis, particularly in patients with contraindications to systemic therapy.
    • Early diagnosis and appropriate treatment are crucial for managing cutaneous leishmaniasis and preventing complications.