Zhuang L, Su J, Tu P. Cutaneous leishmaniasis presenting with painless ulcer on the right forearm: A case report. World J Clin Cases 2022; 10(7): 2301-2306 [PMID: 35321164 DOI: 10.12998/wjcc.v10.i7.2301]
Corresponding Author of This Article
Ping Tu, Doctor, Senior Consultant Dermatologist, Department of Dermatology, Peking University The First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. tup0207@sina.com
Research Domain of This Article
Dermatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2022; 10(7): 2301-2306 Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2301
Cutaneous leishmaniasis presenting with painless ulcer on the right forearm: A case report
Le Zhuang, Jing Su, Ping Tu
Le Zhuang, Ping Tu, Department of Dermatology, Peking University The First Hospital, Beijing 100034, China
Le Zhuang, Department of Dermatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong province, China
Jing Su, Department of Pathology, School of Basic Medical Sciences, The Third Hospital, Peking University Health Science Center, Beijing 100034, China
Author contributions: Tu P conceived the idea and designed the report; Zhuang L and Su J collected the patient’s clinical data; Zhuang L wrote the paper; all authors reviewed the results and approved the final version of the manuscript.
Informed consent statement: The authors have obtained the patient consent form. In the form, the patient gave his consent for his images and other clinical information to be reported in the article. The patient understood that his names and initials will not be published and due efforts will be made to conceal the identity of the patient, although anonymity cannot be guaranteed.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016)
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping Tu, Doctor, Senior Consultant Dermatologist, Department of Dermatology, Peking University The First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. tup0207@sina.com
Received: September 29, 2021 Peer-review started: September 29, 2021 First decision: December 2, 2021 Revised: December 13, 2021 Accepted: January 19, 2022 Article in press: January 19, 2022 Published online: March 6, 2022 Processing time: 153 Days and 17.1 Hours
Abstract
BACKGROUND
Leishmaniasis includes a range of chronic infections in humans and animals and can be caused by more than 20 species of Leishmania protozoa. The manifestations of leishmaniasis are diverse and dependent on the immune response capacity of the host and the type of Leishmania. In East Asia, leishmaniasis is relatively rare and prone to misdiagnosis and underdiagnosis.
CASE SUMMARY
We report a case of a 36-year-old male with cutaneous leishmaniasis. The patient had been misdiagnosed with a bacterial skin infection and was given a dressing change and oral levofloxacin, which proved ineffective. Histopathological examination revealed amastigote (Leishman-Donovan body) in the histocytes, and nucleic acid sequencing proved that the pathogen was Leishmania major. The patient was treated successfully by regional injection of sodium gluconate (600 mg) three times. The ulcer healed and did not recur at 1.5-year follow-up.
CONCLUSION
Skin ulcers caused by leishmaniasis are easily misdiagnosed in non-epidemic countries, yet it should not be overlooked.
Core Tip: Cutaneous leishmaniasis is caused by Leishmania protozoan infection. The most common vector is the sandfly. It often presents as ulcerative plaques and nodules on exposed skin. Because cutaneous leishmaniasis is rare in East Asia, it is often misdiagnosed and underdiagnosed. We hope that this case will draw the attention of clinicians and increase the knowledge of differential diagnosis of skin ulcers.
