Localized cutaneous leishmaniasis of the plantar region: a 40-year outcome.
We report the case of a 78-year-old male Brazilian farmer, who presented with an extensive ulcer on the right foot that had an erythematous and raised border. This ulcer involved most of the right plantar region and had persisted for more than 40 years. Satellite erythematous papules and tumor-like growths were also seen on the right ankle. Extracutaneous involvement was not found. Light microscopy showed epithelial hyperplasia and diffuse histiocyte infiltration with intense plasmocytosis. Cultures for fungi and Leishmania were negative. The polymerase chain reaction with specific primers for Leishmania was performed using DNA extracted from the lesions; it showed an amplification of 120 pB. The patient had an excellent response after two 20-day cycles of intra-venous N-methylglucamine antimonate (15 mg/Kg/day). Leishmaniasis should be highly considered in the differential diagnosis of chronic ulcers in endemic areas.
Diehl
Eduardo Schenini
ES
Ura
Somei
S
Fleury
Raul Negrão
RN
de Almeida
Hiram Larangeira
HL
Barral
Aldina Maria Prado
AM
D000368:Aged; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage; D016054:DNA, Protozoan; D004334:Drug Administration Schedule; D005528:Foot; D005784:Gene Amplification; D006801:Humans; D007275:Injections, Intravenous; D007891:Leishmania / Q000235:genetics; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008499:Medical Records; D008536:Meglumine / Q000008:administration & dosage; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000008:administration & dosage; D016896:Treatment Outcome
D000981:Antiprotozoal Agents; D016054:DNA, Protozoan; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate