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DISSEMINATED CUTANEOUS LEISHMANIASIS DUE TO LEISHMANIA GUYANENSIS: CASE OF A PATIENT WITH 425 LESIONS

Disseminated cutaneous leishmaniasis is characterized by the presence of a large (10) number of lesions at several anatomic sites (head, limbs, and trunk). Most of the lesions are small, papular, and appear simultaneously with or secondarily to one or several ulcerated lesions of localized cutaneous leishmaniasis. We report the first case of disseminated cutaneous leishmaniasis in French Guiana. It concerns a 24-year-old woman who tested negative for human immunodeficiency virus (HIV). The disease began with three lesions that became ulcerated. One week later, multiple papulo-nodular lesions appeared. We counted a total of 425 lesions. Leishmania were observed in the lesions. The species involved was L. guyanensis, which has never been described in a case of disseminated cutaneous leishmaniasis. The patient was rapidly cured by a single course of pentamidine. Disseminated cutaneous leishmaniasis should be distinguished from other types of leishmaniasis with multiple lesions. These include anergic diffuse cutaneous leishmaniasis, post-kala-azar leishmaniasis, and leishmaniasis associated with HIV infection.

Received October 5, 2003. Accepted for publication February 3, 2004.

Authors’ addresses: P. Couppié and R. Pradinaud, Institut Guyanais de Dermatologie Tropicale, Service de Dermatologie C. H. de Cayenne, Rue des Flamboyants, BP 6006, 97300 Cayenne, French Guiana, et Equipe d’Accueil 3593, Faculté de Médecine Antilles-Guyane, Telephone: 594-39-53-59, Fax: 594-39-52-83, E-mail: couppie.pierre{at}voila.fr. E. Clyti and D. Sainte-Marie, Institut Guyanais de Dermatologie Tropicale, Service de Dermatologie C. H. de Cayenne, Rue des Flamboyants, BP 6006, 97300 Cayenne, French Guiana. J. P. Dedet, Centre National de Référence des Leishmanies, Centre Hospitalier Universitaire de Montpellier, Montpellier, France. B. Carme, Service Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, French Guiana et Equipe d’Accueil 3593, Faculté de Médecine Antilles-Guyane.

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