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Diffuse cutaneous leishmaniasis with atypical aspects.

A L Bittencourt1, A Barral, J M Costa

  • 1Department of Pathology, School of Medicine, Universidade Federal da Bahia, Brazil.

International Journal of Dermatology
|August 1, 1992
PubMed
Summary
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This study details a rare case of diffuse cutaneous leishmaniasis in a 16-year-old male, highlighting atypical eosinophil involvement in Leishmania mexicana amazonensis infection.

Area of Science:

  • Medical Parasitology
  • Immunology
  • Dermatology

Background:

  • Diffuse cutaneous leishmaniasis (DCL) is a rare form of leishmaniasis characterized by widespread skin lesions.
  • Leishmania mexicana amazonensis is a species of protozoan parasite known to cause cutaneous leishmaniasis.

Observation:

  • A 16-year-old male presented with long-standing DCL, featuring infiltrated lesions rich in amastigotes but lacking mucosal involvement and a specific cell-mediated immune response.
  • Atypical clinical findings included deep, extensive ulcerations on the lower limbs.
  • Histological examination revealed a significant presence of eosinophils within the tissue infiltrate, particularly in ulcerated areas.

Findings:

  • Monoclonal antibodies confirmed Leishmania mexicana amazonensis in situ.

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  • Ultrastructural analysis showed parasitized and lysed eosinophils near infected macrophages, with eosinophil granule dispersion.
  • The immune response in this case was characterized by a lack of parasite-specific cell-mediated immunity and an unusual abundance of eosinophils.

    • Implications:

    • This case expands the understanding of clinical and histological variations in diffuse cutaneous leishmaniasis.
    • The role of eosinophils in Leishmania mexicana amazonensis infection warrants further investigation.
    • Understanding atypical immune responses is crucial for developing effective diagnostic and therapeutic strategies for leishmaniasis.