title: [Cutaneous leishmania in HIV patient in Ouagadougou: clinical and therapeutic aspects].
abstract: BACKGROUND
  Immune suppression cause by HIV infection is a risk factor in the progression of leishmania diseases. In Burkina Faso atypical clinical presentations of leishmaniases have been observed among people living with HIV. The goal of this study was to describe clinical and evolutionary aspects of cutaneous leishmania and HIV co-infection among patients followed at Ouagadougou University Hospital.
  
  
  METHODS
  This 16-month prospective study was carried out from January 2003 to April 2004 among HIV-seropositive patients with a diagnosed cutaneous leishmania infection. At baseline, infection and lesions were classified. Clinical diagnosis of cutaneous leishmania depended on finding parasites by microscopy in smears or tissue biopsies. Histological examinations were done if clinical and parasitological diagnosis were not concordant. Treatment consisted of three 21-day rounds of pentavalent antimonial, (Glucantime(R)). Clinical evolution was monitored at the end of each treatment round.
  
  
  RESULTS
  Thirty-two HIV-1 positive patients (16 women and 16 men) were included. Mean age was 35.5 (10-67 years old). Leishmania lesions had been evolving, on average, for 12 weeks. Eleven patients were taking HAART and 21 patients were taking cotrimoxazole prophylaxis against opportunistic infections. Cutaneous lesions were found: in the face (15 cases), torso (18 cases), upperlimbs (26 cases) and lower-limbs (28 cases). Observed clinical forms were: papulo-nodular (9 cases), ulcerative (14 cases), infiltrative (12 cases), lepromatous and diffuse (15 cases), psoriasis-like (5 cases), cheloid, histioid or kaposi-like (1 case each). Some patients presented more than one clinical form. Prognosis was satisfactory in 24 patients after the first treatment. Twelve patients relapsed after the first treatment, among those 10 were only taking cotrimoxazole. At the end of the third treatment, 24 patients were cured, 3 died and 5 were lost to follow-up.
  
  
  CONCLUSIONS
  Clinical polymorphism of cutaneous leishmania has been observed in HIV-patients, thereby increasing the risk of differential diagnosis.
authors.affiliation: Service de Dermatologie Vénérologie, CHU YO, Ouagadougou, Burkina Faso. niamba_pascal@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Niamba
authors.forename: A
authors.initials: A
authors.lastname: Traoré
authors.forename: O
authors.initials: O
authors.lastname: Goumbri-Lompo
authors.forename: C
authors.initials: C
authors.lastname: Labrèze
authors.forename: F
authors.initials: F
authors.lastname: Traoré-Barro
authors.forename: M
authors.initials: M
authors.lastname: Bonkoungou
authors.forename: L
authors.initials: L
authors.lastname: Ilboudo
authors.forename: A
authors.initials: A
authors.lastname: Gaulier
authors.forename: B-R
authors.initials: BR
authors.lastname: Soudré
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002050:Burkina Faso; D002648:Child; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination