Atypical manifestations of tegumentary leishmaniasis in a transmission area of Leishmania braziliensis in the state of Bahia, Brazil

Abstract

Summary American tegumentary leishmaniasis (ATL) can occur in different forms, classically categorized as cutaneous leishmaniasis (CL), mucosal leishmaniasis (ML), diffuse cutaneous leishmaniasis and disseminated leishmaniasis. Atypical ATL have been described in sporadic case reports. In this study we analyzed the presence of atypical manifestations (vegetative, verrucous, crusted and lupoid) among a cohort of all patients presenting to the Health Post of Corte de Pedra. Among 1396 patients diagnosed with ATL in 2005–06, 35 (2.5%) patients presented with atypical manifestations of the disease. Of these patients, 14 were pregnant women, 2 were co-infected with HIV, and 19 had no comorbidity or other apparent risk factors for the development of atypical ATL. These 19 patients were the focus of this study. They were predominantly adult males, frequently presenting with facial lesions (p< 0.001 OR=17.5 CI 95% 6.1 – 52.4) and had higher rates of treatment failure with antimony therapy (p< 0.001 OR= 327 CI 95% 45 – 6668) when compared with patients with classic ATL attended in the same period.

Autochthonous Disseminated Dermal and Visceral Leishmaniasis in an AIDS Patient, Southern Thailand, Caused by Leishmania siamensis

“…Dermatological manifestations in this patient were similar to those manifestations previously described in AIDS patients who were infected with L. infantum and L. donovani. 7,8 In this case, the cause of anemia, which might be caused by leishmaniasis, was not properly investigated. Dermal lesions were later developed after amphotericin B was not given.…”

Epidemiological and Clinical Changes in American Tegumentary Leishmaniasis in an Area of Leishmania (Viannia) braziliensis Transmission Over a 20-Year Period

“…More recently, atypical forms of the disease have been described, such as verrucous lesions and multiple nodular lesions in a specific area of the body. 4 For the past 25 years, patients in this endemic region have been followed at the Health Post of Corte de Pedra. Over the course of the past two decades, clinicians have noted an increase in the number of cases of more severe disease (namely mucosal and disseminated leishmaniasis), a decrease in the efficacy of antimonials, and changes in the demographics of the patient population.…”

“…Over the course of the past two decades, clinicians have noted an increase in the number of cases of more severe disease (namely mucosal and disseminated leishmaniasis), a decrease in the efficacy of antimonials, and changes in the demographics of the patient population. 4,5 The last epidemiological study in the region performed in 1985 revealed an annual incidence of disease of 8.1 per 1,000 inhabitants and a prevalence of 14.9%. 6 Peak occurrence of ATL was observed in male patients between 10 and 15 years of age.…”

Hyperkeratotic cutaneous leishmaniasis: A rare presentation

“…Most previous studies of leishmaniasis were based in the New World region. Northeast American tegumentary leishmaniasis was reported in the hyperkeratotic form of CL (2). Since CL is locally endemic, we suspected CL in this lesion, which had not healed for a long time.…”