[A Pediatric case of lupoid leishmaniasis diagnosed by PCR].
The purpose of this paper is to describe the clinical features of lupoid leishmaniasis in a child and to underline the use of PRC as a necessary and reliable tool in controversial diagnosis. Lupoid leishmaniasis, also known as chronic or relapsing leishmaniasis, is mainly widespread in the Middle East, where it represents up to 5% of all cutaneous Leishmaniasis. It strongly resembles Lupus Vulgaris, both clinically and histologically, and is therefore not usually diagnosed immediately but after a certain period of time. The amastigotic forms are rare or absent. The cutaneous nodules or plaques can slowly enlarge over the years. The case of an eleven-year-old albanian child living in Durazzo (Albania), suffering since three years with a plaque formed by apple-jelly nodules and scars on his right cheek, is presented. Using PCR, the presence of Leishmania infantum DNA led to a diagnosis of lupoid leishmaniasis. The therapeutic strategy of a combination of oral itraconazole and infiltration of metilglucamina antimoniate has been carried out, with good result, as checked through "telemedicine".
Paradisi
M
M
VII Divisione Dermatologia Pediatrica, IDI IRCCS, Roma. m.paradisi@idi.it
Grosso
M G
MG
Angelo
C
C
Gradoni
L
L
Ludovisi
A
A
N'Doni
F
F
Puddu
P
P
D000284:Administration, Oral; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000965:Antimony / Q000008:administration & dosage / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D016054:DNA, Protozoan / Q000032:analysis; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use; D018314:Leishmania infantum / Q000235:genetics; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy; D008177:Lupus Vulgaris / Q000175:diagnosis; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D013997:Time Factors
D000935:Antifungal Agents; D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D017964:Itraconazole; D008536:Meglumine; D000965:Antimony