title: Ulcerated disseminated cutaneous leishmaniasis associated with vitiligo, hypothyroidism, and diabetes mellitus in a patient with Down syndrome.
abstract: We report a 35-year-old man who was referred to our dermatology department with multiple, nodular, ulcerated, and crusted lesions disseminated on the face, trunk, and extremities. He has a known diagnosis of Down syndrome. The past medical history also included vitiligo (for 20 years), hypothyroidism (for 2 years), and type-II diabetes mellitus (for 3 months). Direct smear of an ulcer was positive for leishmania. Skin biopsy confirmed the diagnosis. A leishmanin skin test was negative. Polymerase chain reaction (PCR) from two separate skin biopsies demonstrated the presence of Leishmania major. To our knowledge, this is the first report of disseminated cutaneous leishmaniasis (DCL) caused by L. major in Iran, and also the first report of association between DCL with Down syndrome, vitiligo, hypothyroidism, and diabetes mellitus.
authors.affiliation: Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran. shahinaghaei@yahoo.com
authors.forename: Shahin
authors.initials: S
authors.lastname: Aghaei
authors.forename: Rahmat
authors.initials: R
authors.lastname: Salmanpour
authors.forename: Farhad
authors.initials: F
authors.lastname: Handjani
authors.forename: Ahmad
authors.initials: A
authors.lastname: Monabati
authors.forename: Nazila
authors.initials: N
authors.lastname: Mazharinia
authors.forename: Ladan
authors.initials: L
authors.lastname: Dastgheib
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004314:Down Syndrome / Q000150:complications*; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000473:pathology; D008297:Male; D012883:Skin Ulcer / Q000150:complications* / Q000473:pathology; D014820:Vitiligo / Q000150:complications*