Butterfly rash due to cutaneous leishmaniasis

Area of Science:

• Dermatology
• Infectious Diseases
• Medical Parasitology

Background:

• Cutaneous leishmaniasis (CL) exhibits diverse clinical presentations, often complicating diagnosis.
• The differential diagnosis of facial rashes is broad, including autoimmune conditions like systemic lupus erythematosus (SLE).
• Misdiagnosis can delay appropriate treatment, potentially leading to prolonged morbidity.

Purpose of the Study:

• To report a rare case of cutaneous leishmaniasis mimicking systemic lupus erythematosus.
• To emphasize the importance of considering leishmaniasis in the differential diagnosis of facial dermatoses.
• To illustrate the successful management of a cosmetically sensitive CL lesion.

Main Methods:

• Clinical presentation of a 55-year-old female with a facial rash.
• Diagnostic workup including histopathology.
• Treatment with antimonials for confirmed cutaneous leishmaniasis.

Main Results:

• The patient presented with a facial rash resembling the butterfly distribution characteristic of SLE.
• Histopathology confirmed the diagnosis of cutaneous leishmaniasis, despite the initial misdiagnosis.
• Treatment with antimonials resulted in significant clinical improvement within three weeks, with reduced swelling and redness.

Conclusions:

• Cutaneous leishmaniasis can present with unusual clinical manifestations, such as a lupus-like facial rash.
• Diagnostic vigilance and appropriate laboratory investigations are crucial for accurate CL diagnosis.
• Antimonial therapy is effective for managing cosmetically sensitive cutaneous leishmaniasis lesions.