Atypical presentations of cutaneous leishmaniasis in Morocco: Emerging clinical and epidemiological trends

Cutaneous leishmaniasis (CL) is an endemic parasitic disease in Morocco that exhibits an increasing diversity of clinical manifestations. This clinical polymorphism often leads to misdiagnosis and delays in treatment. The aim of our study was to illustrate the atypical presentations of CL through a series of six cases diagnosed in our department, highlighting the diagnostic challenges and public health implications.

We report six atypical cases of CL. Case 1: a 33-year-old male with an ulcerative and crusty lesion on the lower lip mucosa, mimicking epidermoid carcinoma. Case 2: a 44-year-old male with a chondritis-like erythematosquamous plaque on the left ear. Case 3: a 25-year-old male with a well-limited erosive plaque on the right arm, developed leishmaniasis recidivans. Case 4: a 53-year-old female with ulcero-verrucous facial lesions and concomitant cutaneous lupus. Case 5: a 69-year-old female with sarcoidosis-like papulo-nodular facial lesions and an infiltrated nasal plaque mimicking lupus pernio. Case 6: a 75-year-old female with a crateriform lesion on the nose suggestive of keratoacanthoma.

These cases illustrate the changing clinical and epidemiological profile of CL in Morocco, highlighting the importance of early recognition and precise diagnosis through detailed anamnesis and parasitological examinations. It underlines the necessity for enhanced epidemiological surveillance and awareness-raising among practitioners to improve the management and control of the disease.