Erysipeloid Cutaneous Leishmaniasis B55.1

Last updated on: 04.10.2022

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Definition
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The erysipelas-like form of Old World cutaneous leishmaniasis is a rare variant of cutaneous leishmaniasis. Because the clinical picture is unusual, there is often a delay in diagnosis.

Localization
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Only to areas of skin that are worn freely.

Clinical features
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Erysipelas-like clinical picture with formation of a slowly progressive erythematous , little painful plaque. No fever, no local pain, no regional lymphadenopathy.

Diagnosis
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Diagnosis is based on direct parasitological examination, detection of Leishmania DNA by PCR, and histological examination.

Note(s)
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In Old World cutaneous leishmaniasis, there are a number of morphologic variants:

  • acute paronychial leishmaniasis
  • chankriform leishmaniasis
  • anular leishmaniasis
  • palmoplantar leishmaniasis
  • zosteriform leishmaniasis
  • eczematoid leishmaniasis.

Clinical morphology depends on the immune status of the patient, the Leishmania subspecies, and the site of infection. A diffuse, erysipelas-like form is unusual, and is worthy of attention for differential diagnostic reasons alone, in contrast to erysipelas.

Case report(s)
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The 63-year-old traveler to Iran (stay 1 month before onset of illness) presented because of a slowly enlarging red plaque on the left cheek that had been present for 5 months. Various antibiotic pretreatments were without effect. Clinical examination revealed a rich red, little painful, surface-smooth, moderately consistent enlarged plaque. No fever, no regional lymphadenopathy, no CRP elevation. The diagnosis of cutaneous leishmaniasis was made bioptically. Intramuscular treatment with meglumine antimonate at a dose of 20 mg/kg per day was administered.

Literature
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  1. Parajuli N et al (2020) Case Report: Erysipeloid Cutaneous Leishmaniasis Treated with Oral Miltefosine. Am J Trop Med Hyg 104:643-645.
  2. El kartouti A et al (2015) Leishmaniose cutanée érysipéloide: à propos d'une observation clinique. Pan Afr Med J 21:54.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Last updated on: 04.10.2022