title: Cutaneous Leishmaniasis - Dermoscopic Findings And Cryotherapy.
abstract: We present a 60-year-old male patient who, three months after a holiday in Southern Greece, found a small 'pimple' on his back, which gradually got as big as a small walnut, the central part becoming ulcerated and scabby. Dermatological examination found an erythematous-to-livid nodular lesion on the right shoulder; it was 16 mm in diameter with central ulceration, covered with brownish crust which discharged pus-like secretion upon pressure. Microscope examination of Romanowsky-Giemsa stained lesion material detected amastigote forms of Leishmania tropica. The culture investigation and serological tests for leishmaniasis were negative. Dermoscopy of the lesion found the following features: erythema, hyperkeratosis, central ulceration covered with brownish crust, "yellow tears-like" structures and "white starburst-like" patterns, and various vascular structures (including dotted vessels, comma-shaped vessels, hairpin- and glomerular-like vessels). The patient was diagnosed with cutaneous leishmaniasis and underwent four cryotherapy sessions every other week with excellent therapeutic results - complete resolution of infiltrate with subsequent gentle hypopigmented scarring. In conclusion, dermoscopy is an easily accessible non-invasive method which can be useful for the diagnosis of cutaneous leishmaniasis. Cryotherapy is the treatment of choice for single skin lesions.
authors.affiliation: Department of Dermatology and Venereology
authors.forename: Hristo P
authors.initials: HP
authors.lastname: Dobrev
authors.affiliation: Department of Dermatology and Venereology
authors.forename: Desislava G
authors.initials: DG
authors.lastname: Nocheva
authors.affiliation: Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical Faculty, Medical University, Plovdi
authors.forename: Dimitar Iv
authors.initials: DI
authors.lastname: Vuchev
authors.affiliation: Dermatological Surgery, Alexandrovska Medical, Bulgaria
authors.forename: Rumyana D
authors.initials: RD
authors.lastname: Grancharova
mesh_terms: D017679:Cryotherapy; D046169:Dermoscopy; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged