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Leishmaniasis presenting as a dermatomyositis-like eruption in AIDS
1Department of Dermatology, Hospital de la Princesa, Universidad Autónoma, Madrid, Spain.
Journal of the American Academy of Dermatology
|August 1, 1996
Summary
Leishmaniasis in patients with AIDS can cause skin lesions that resemble dermatomyositis. Prompt treatment for leishmaniasis effectively resolved these distinctive cutaneous manifestations.
Area of Science:
- Dermatology
- Infectious Diseases
- Immunology
Background:
- Leishmaniasis is a parasitic disease with diverse clinical presentations.
- Acquired immunodeficiency syndrome (AIDS) can alter the clinical course of leishmaniasis.
- Dermatomyositis is an autoimmune disease characterized by muscle and skin inflammation.
Observation:
- Three patients with co-existing leishmaniasis and AIDS presented with cutaneous lesions mimicking dermatomyositis.
- Leishmania organisms were abundant in the dermis and, in one case, within epidermal keratinocytes.
- Skin and bone marrow cultures confirmed Leishmania infantum infection.
Findings:
- The clinical presentation, absence of characteristic dermatomyositis markers (muscle weakness, elevated enzymes, specific EMG/histopathology), and rapid response to leishmaniasis treatment indicated a dermatomyositis-like eruption.
- Leishmania organisms were detected in both lesional and non-lesional skin.
Implications:
- Leishmaniasis should be considered in the differential diagnosis of dermatomyositis-like skin eruptions, particularly in immunocompromised individuals.
- This finding highlights the potential for parasitic infections to induce autoimmune-like symptoms.
- Early diagnosis and treatment of leishmaniasis are crucial for managing these atypical presentations.