title: Contact dermatitis-like cutaneous leishmaniasis in a Libyan HIV patient.
abstract: BACKGROUND
  Cutaneous leishmaniasis (CL) is one of the common tropical protozoal diseases caused by various Leishmania species, and transmitted by the sand-fly vectors, Phlebotomus and Lutzomyia species. Herein, we report for the first time a case of CL that presented as large eczematous plaques occurring on the dorsi of both feet in a Libyan drug addicted, alcoholic patient with HIV infection.
  
  
  RESULTS
  A 34 year-old HIV-positive, alcoholic, drug addicted Libyan male presented to us with a history of a non-itchy skin lesions on the dorsi of both feet of 5-weeks duration. Systemic and topical antibiotics were given without improvement. Diagnosis of this patient was confirmed by observation of Leishmania amastigote bodies in stained slit-skin smear skin biopsy. After parenteral administration of sodium stiboglyconate (Pentostam) (20 mg/kg/day) for 28 days the lesions did not show any marked improvement. Concurrently, combination therapy of oral rifampicin (600 mg/day) and isoniazide (300 mg/day) was given for 8 weeks. Complete healing of lesions was achieved after this treatment and skin-slit smears turned negative.
  
  
  CONCLUSIONS
  Localized cutaneous leishmaniasis should be remembered in deferential diagnosis of unresponsive contact dermatitis especially for HIV-positive patients in CL endemic areas.This patient was not responding to Pentostam therapy, which is not very common in Libya. Interestingly, combination of oral rifampicin (600 mg/day) and isoniazide (300 mg/day) can be a successful alternative therapy.
authors.forename: Hamida
authors.initials: H
authors.lastname: Al-Dwibe
authors.forename: Aisha
authors.initials: A
authors.lastname: Gashout
authors.forename: Abdu-Maged
authors.initials: AM
authors.lastname: Morogum
authors.forename: Said
authors.initials: S
authors.lastname: El-Zubi
authors.affiliation: Faculty of Pharmacy, Alquds University, Main Campus, P,O, Box 5100, Abu Dis, Jerusalem, Palestine. aamro@pharm.alquds.edu.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Amro
mesh_terms: D000328:Adult; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D054872:Fatty Acid Synthesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage / Q000627:therapeutic use; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000473:pathology*; D008297:Male; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D012867:Skin / Q000469:parasitology / Q000473:pathology
chemical_list: D000981:Antiprotozoal Agents; D054872:Fatty Acid Synthesis Inhibitors; D019384:Nucleic Acid Synthesis Inhibitors; D007538:Isoniazid; D012293:Rifampin