Unusual manifestation of genital cutaneous leishmaniasis in an immunocompetent patient from São Paulo, Brazil: A case report

Abstract

A 31-year-old male patient developed an ulcer on the glans penis that evolved for three months without healing. We diagnosed it as leishmaniasis using polymerase chain reaction. No immunosuppression or associated diseases were observed. The patient was treated with meglumine antimoniate that cured the lesion in a month post-treatment. Here, we report this case of cutaneous leishmaniasis lesion at the unusual location of glans penis in an immunocompetent individual. The lesion likely developed due to the bite of a vector, highlighting the need for considering cutaneous leishmaniasis among differential diagnosis of sexually transmitted diseases in areas endemic for leishmaniasis.

Case report and literature review: Genital leishmaniasis

“…Cutaneous leishmaniasis is more frequently seen on exposed body areas such as the face, eyelids, forehead, hands, wrists and, occasionally, the legs. The involvement of the genitals is rare, although there are previous reports of infection of the penis [3] , [4] , [5] , [6] , [7] , [8] , [9] . The ages of those so infected range from infancy to octogenarians [10] , [11] .…”

Unusual Observations in Leishmaniasis—An Overview

“…CL lesions on the glans penis and scrotum are generally painless and could be ulcerative [ 150 , 151 , 152 , 153 ]. The diagnosis of leishmaniasis was made by histopathological examination and/or PCR and the preferred treatment was cryotherapy [ 154 , 155 ]. Differential diagnosis includes squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, lymphoma and viral infections such as human papillomavirus (HPV), human immunodeficiency virus (HIV), syphilis, fungal infections, bacterial infections and psoriasis [ 154 , 155 ].…”