Exuberant case of verrucous cutaneous leishmaniasis

Area of Science:

• Dermatology
• Infectious Diseases
• Parasitology

Background:

• Cutaneous leishmaniasis (CL) is a significant global public health concern, endemic in Brazil with considerable socioeconomic impact.
• Leishmania braziliensis is a primary causative agent of CL in South America, often presenting with diverse clinical manifestations.

Observation:

• This report details an unusual case of CL in a 28-year-old male with Down syndrome presenting with extensive verrucous plaques on his back over a year.
• The patient's lesions showed progressive growth, indicating a challenging clinical course.

Findings:

• Polymerase Chain Reaction (PCR) confirmed the presence of Leishmania braziliensis in the lesion sample.
• The patient's condition was diagnosed as atypical cutaneous leishmaniasis.
• Successful treatment was achieved using a combination of amphotericin B and miltefosine.

Implications:

• This case underscores the importance of considering atypical presentations of CL, particularly in immunocompromised or genetically distinct populations.
• The successful treatment highlights potential therapeutic options, but the inherent challenges of drug toxicity and variable cure rates for CL necessitate further research into novel therapeutic strategies.