Disseminated cutaneous leishmaniasis

Disseminated cutaneous leishmaniasis DCL is a condition rarely seen in the Middle East. We report a case of disseminated cutaneous leishmaniasis in a 60-years-old lady. The patient first presented 1996 with an initial lesion, which started on the butterfly area of the face and spread, probably due to immunosuppression, to involve the whole face. The lesions consisted of nodules, which did not ulcerate. The histology showed abundance of macrophages filled with amastigotes L-D bodies. The patient was started on oral zinc sulphate 10 mg/kg in 3 divided doses daily. The condition showed gradual improvement. Repeated biopsies showed upgrading of the histopathological picture. After 6-months of treatment there was complete clearance of the condition. The patient was followed up for 6-years with no recurrence. However, she presented with a new lesion on the butterfly area again in February 2003. The biopsy again showed abundance of macrophages filled with amastigotes L-D bodies. A 4-months course of zinc sulphate 10 mg/kg in 3 divided doses daily resulted in complete clearance of the lesions. Zinc sulphate might represent a new treatment for this condition that has no adequate treatment until now.