Squamous cell carcinoma arising from chronic cutaneous leishmaniasis: a rare case report

Leishmaniasis is a parasitic disease transmitted by sandflies, commonly manifesting as cutaneous or mucocutaneous lesions. While cutaneous leishmaniasis (CL) is widespread in endemic regions, its link to malignancies like squamous cell carcinoma (SCC) remains uncertain. We report a rare case of SCC developing directly on a CL lesion, contributing to the ongoing debate regarding this potential association. A 75-year-old man from an endemic region presented with a red papule following an insect bite. Despite receiving 6 sessions of intralesional therapy, the lesion worsened due to a one-year lapse in follow-up and use of alternative therapies. Biopsy confirmed moderately differentiated SCC, leading to surgical removal and recovery without complications. The development of SCC on a previous CL lesion is rare but notable, as chronic infections can trigger malignancy. Although no definitive link has been established between CL and SCC, this case underscores the need for monitoring persistent leishmaniasis lesions, especially in mismanaged cases. It also emphasizes the importance of timely diagnosis and treatment of CL to avoid complications such as SCC. Further research is needed to determine the mechanisms underlying this rare association.