Unusual form of cutaneous leishmaniasis: erysipeloid form.
We report the epidemiological and clinical characteristics of the erysipeloid form of cutaneous leishmaniasis as well as its diagnostic and therapeutic challenges.


METHODS
A 63-year-old woman, with no medical history, presented with a one-month history of erythematous nasal swelling. The lesion appeared after an accidental trauma. Erythematous infiltrative plaque was noted on the center of the face. There were also crust formations on the traumatic region. Despite local treatment and oral antibiotherapy, there was no improvement. The diagnosis of cutaneous leishmaniasis was confirmed by positive skin smears. Histopathological examinations of a skin biopsy showed no malignancy. The patient was treated intramuscularly with 10mg/kg per day systemic meglumine antimoniate with partial regression of symptoms.


CONCLUSIONS
The erysipeloid type is a rare and unusual presentation of cutaneous leishmaniasis that often causes late diagnosis. Diagnosis is confirmed by the demonstration of the parasite by skin smear, histopathological examination and polymerase chain reaction. There are various therapeutic options. The evolution is generally favourable.
Service ORL et chirurgie cervico-faciale, CHU Habib Bourguiba, 3029 Sfax, Tunisia.
M
M
Mnejja
B
B
Hammami
A
A
Chakroun
I
I
Achour
I
I
Charfeddine
A
A
Chakroun
H
H
Turki
A
A
Ghorbel
D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D004887:Erysipeloid / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009666:Nose / Q000293:injuries; D009668:Nose Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D009942:Organometallic Compounds / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D012867:Skin / Q000473:pathology
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate