Abstract. Mucosal leishmaniasis (ML) is a chronic form of tegumentary leishmaniasis, which causes destructive lesions of nasal, pharyngeal, and laryngeal mucosa. We describe a case of leishmaniasis reactivation with simultaneous cutaneous and mucosal forms in a renal transplanted patient with no history of prior leishmaniasis. Reactivation after renal transplantation was not reported in Brazil. A 67-year-old woman receiving prednisone 20 mg/day, tacrolimus 1 mg/day, and mycophenolic acid 360 mg/day presented with nose edema with erythema and cutaneous lesions. Amastigotes were identified on biopsies and the polymerase chain reaction confirmed Leishmania (Viannia) braziliensis. The patient was treated with liposomal amphotericin B but died 3 weeks after as a result of bacterial septic shock. In conclusion, tegumentary leishmaniasis can reactivate with simultaneous cutaneous and mucosal forms in a renal transplanted patient during the immunosuppressant therapy.
Morbihan Syndrome is a rare entity with unknown etiology. It is clinically
characterized by chronic erythematous edema on the face - especially in the
middle and upper third of the face - and creates abnormal facial contours
that are initially intermitent but become permanent with the development of
the syndrome. The histopathology is nonspecific and its therapy is a major
challenge due to poor response to the various treatment options. We present
the case of a male patient with a five-month-history of disease.
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