Cutaneous sporotrichoid leishmaniasis resistant to pentavalent  antimonial therapy: complete resolution with itraconazole.
Sporotrichoid leishmaniasis is a sporadic form of cutaneous leishmaniasis, a protozoal infection, reported particularly in the Middle East. Clinically it occurs as nontender, subcutaneous, slightly erythematous nodules, often associated with lymphangitis, usually on exposed areas of the skin. Sometimes it occurs after treatment with a single dose of antimonials, and in older lesions, the biopsy can be negative for amastigotes. We report a case of cutaneous sporotrichoid leishmaniasis unresponsive to intralesional pentavalent antimonial therapy, which completely resolved after treatment with oral itraconazole. To our knowledge, this is only the third such case reported. We discuss the causes of dissemination of the nodular lesions and the negative results for amastigotes on re-biopsed lesions.
Cozzani
E
E
Section of Dermatology, Di.S.E.M., University of Genoa, Genoa, Italy.
Satta
R
R
Fausti
V
V
Cottoni
F
F
Parodi
A
A
D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D001706:Biopsy; D004351:Drug Resistance; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole