Cutaneous Leishmaniasis of the Eyelids: A Case Series with Molecular Identification and Literature Review

Abstract

Cutaneous leishmaniasis (CL) is a protozoan disease which is endemic in Iran. It is transmitted by the Phlebotomus sand fly. The eyelid is rarely involved possibly because the movement of the lids impedes the sand fly from biting the skin in this region. Here, we report 6 rare cases of eyelid CL. The patients were diagnosed by skin scraping, culture, and PCR from the lesions. Skin scraping examination showed Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for Leishmania major and Leishmania tropica. The lesions were disguised as basal cell carcinoma, chalazion, hordeolum, and impetigo. The patients were treated with intramuscular meglumine antimoniate (20 mg/kg/day) for at least 3 weeks. They showed a dramatic response, and the lesions almost completely disappeared. We emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic relationship of isolated parasites, and reviewed the literature on ocular leishmaniasis.

Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial

“…Multiple smears were made on slides and were both air dried and alcohol fixed and then stained by the Wright method. [ 47 , 48 ] Review of cytological smears was conducted by a single expert laboratory personnel. Microscopic examination showed the amastigote forms of Leishmania in magnification, ×200.…”

Incidence and predisposing factors of chalazion

“…3,[13][14][15]18 Other less associated factors include immune deficiency states, hyperlipidemia, tuberculosis, and leishmaniasis. 19,14,20,21 These predisposing factors will be reviewed in this section.…”

Case Report: Mucocutaneous Leishmaniasis Masquerading as Idiopathic Midline Granulomatous Disease

“…Liposomal amphotericin B with cumulative doses of 20-60 mg/kg has been used to effectively treat ML in immunocompetent hosts. 20,21 Ocular leishmaniasis involving the eyelid or conjunctiva has been successfully treated with pentavalent antimony, [22][23][24][25][26] miltefosine, 27 intralesional amphotericin B, 12 or with surgical excisional alone. 11 Close follow-up is recommended for ML, as treatment response is generally less responsive than for CL, and post-treatment relapse is more common.…”