American cutaneous leishmaniasis triggered by electrocoagulation

Abstract

Cutaneous leishmaniasis is usually transmitted by infected phlebotomine sand fly bites that initiate local cutaneous lesions. Few reports in the literature describe other modes of transmission. We report a case of a previously healthy 59-year-old woman who underwent electrocoagulation to remove seborrheic keratosis confirmed by dermatoscopy. Three months later, a skin fragment tested positive for Leishmania culture; the parasite was identified as L. (V.) braziliensis. Trauma may generate inflammatory cascades that favor Leishmania growth and lesion formation in previously infected patients. American cutaneous leishmaniasis is a dynamic disease with unclear pathophysiology because of continually changing environments, demographics, and human behaviors.

Mucocutaneous leishmaniasis in a cocaine user: diagnostic and therapeutic knowledge

“…This trauma generates an inflammatory cascade that could favor Leishmania dissemination and lesion formation in previously infected patients. This hypothesis is supported by the local release of immunosuppressive cytokines and transforming growth factor-p, which exacerbates lesion development 6 .…”

Clinical Manifestation of Cutaneous Leishmaniasis Following a Mechanical Trauma

“…For example, Martins et al reported on a patient in whom cutaneous leishmaniasis was triggered by electrocoagulation. 17 In other cases, minor traumas, like manipulating a pimple, a bee sting, or a submucosal nasal resection, were also sufficient to elicit the development of a Leishmania ulcer. 12,18 Long 19 reported a case of a 24-year-old North American Veteran, who was admitted with an enlarging Leishmania sore at the forehead, after having been to the Panama Canal Zone on duty with the US army.…”

Pathophysiology of Leishmaniasis

“…The metacyclic promastigotes possess the ability to induce infection. When the insect bites a healthy animal, it spreads the infection by expelling these promastigotes through regurgitation [37].…”

“…Moreover, the close closeness of sand flies to human owners can heighten the rate of transmission [39]. This is because human owners provide blood meals for sand flies and organic dung for their larval rearing and resting [37] bovine sources and 19% from humans. While it has been noticed that household animals can become diseased, there is currently inadequate data to confirm their role in transferring diseases to humans in India and the Indian subcontinent [33].…”