Sporotrichoid leishmaniasis: a cross-sectional clinical, epidemiological and laboratory study in Rio de Janeiro State, Brazil

Abstract

Background Atypical presentations of cutaneous leishmaniasis include sporotrichoid leishmaniasis (SL), which is clinically described as a primary ulcer combined with lymphangitis and nodules and/or ulcerated lesions along its pathway.Aims To assess the differences between patients with sporotrichoid leishmaniasis and typical cutaneous leishmaniasis (CL).Methods From January 2004 to December 2010, 23 cases of SL (4.7%) were detected among 494 CL patients diagnosed at a reference center for the disease in Rio de Janeiro State, Brazil. These 23 cases were compared with the remaining 471 patients presenting CL.Results SL predominated in female patients (60.9%, p = 0.024), with older age (p = 0.032) and with lesions in upper limbs (52.2%, p = 0.028). CL affected more men (64.5%), at younger age, and with a higher number of lesions exclusively in lower limbs (34.8%).Conclusions Differences in clinical and epidemiological presentation were found between SL patients as compared to CL ones, in a region with a known predominance of Leishmania (Viannia) braziliensis. The results are similar to the features of most of the sporotrichosis patients as described in literature, making the differential diagnosis between ATL and sporotrichosis more important in overlapping areas for both diseases, like in Rio de Janeiro State.

Immunopathogenesis of Human Sporotrichosis: What We Already Know

“…Depending on the geographical area where the transmission occurs, other skin and mucosal lesions such as cutaneous leishmaniasis, tuberculosis, and leprosy as well as some neoplastic and bacterial lesions should be taken into account during diagnosis since they may present a similar clinical presentation, making it difficult to diagnose when specific isolation is difficult due to technical problems. For example, in the state of Rio de Janeiro, Brazil, where the areas of transmission of sporotrichosis and American tegumentary leishmaniasis (protozoosis caused by species of the genus Leishmania ) overlap, the presence of single ulcerated lesions may lead to confusion, moreover, the cutaneous form of sporotrichosis might be mistaken for the sporotrichoid form of ATL [ 79 , 80 ] since they can present very similar lesions. In these cases, the epidemiological history associated with a specific diagnostic test, mainly the isolation of the etiological agent, are fundamental in the diagnostic configuration.…”

The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis

“…Tegumentary leishmaniasis is a skin/mucosal granulomatous disease that manifests as cutaneous localized or disseminated ulcers, papules diffusely distributed, mucosal lesions or atypical lesions ( Table 1 ) ( Marzochi and Marzochi, 1994 ; Azeredo-Coutinho et al, 2007 ; Kevric et al, 2015 ; Reis et al, 2016 ; Brazil, 2017 ; Carvalho et al, 2017 ). Marzochi and Marzochi (1994) suggested a clinical approach based on clinical and evolutionary aspects as follow: (1) Localized cutaneous leishmaniasis (LCL), most commonly manifestation of tegumentary leishmaniasis, it is characterized by single or multiple ulcers with varying measures of mm to cm.…”

Síndrome linfocutáneo de causa infecciosa: revisión narrativa y enfoque diagnóstico

“…Se presenta en mujeres hasta en el 60,9% de los casos, siendo el 52,2% correspondientes al grupo etario de 25 a 44 años (61). Las lesiones pueden ser únicas o múltiples, y usualmente se localizan en zonas expuestas a sitios de picadura (3,62) .…”