[Complex cutaneous leishmaniasis with bone involvement]

Area of Science:

• Infectious Diseases
• Parasitology
• Dermatology

Background:

• Cutaneous leishmaniasis (CL) is a parasitic disease primarily affecting the skin.
• Immunocompromised individuals are at higher risk for disseminated and atypical CL presentations.
• Leishmania infantum is a known cause of visceral leishmaniasis and can cause CL.

Observation:

• A single bone lesion in the little toe of an immunocompromised patient was observed.
• The lesion was attributed to Leishmania (L.) infantum infection.
• Diagnosis was confirmed via polymerase chain reaction (PCR) on skin and bone tissue.

Findings:

• This report documents the first instance of osseous involvement in CL caused by Leishmania infantum.
• Polymerase chain reaction (PCR) confirmed Leishmania infantum in both skin and bone tissue.
• The patient achieved successful treatment with miltefosine.

Implications:

• Extracutaneous manifestations of CL, including bone involvement, must be considered in immunocompromised patients.
• This case highlights the importance of thorough investigation for disseminated disease in CL.
• Early detection and appropriate treatment are vital for managing complex CL cases.