1921
Volume 93, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Cutaneous leishmaniasis (CL) is diverse in its clinical presentation but usually demonstrates an erythematous, infiltrated, ulcerated, and crusted papule or nodule in exposed areas of the body. Rare clinical features have been reported including lymphatic dissemination, usually with subcutaneous nodules along lymphatic channels. Herein, we present six patients suffering from Old World CL with lymphatic dissemination characterized by sporotrichoid subcutaneous nodules along the lymphatic channels draining the primary lesion. Patients' history, clinical and laboratory findings were collected and summarized. Lymphatic dissemination of CL in our patients manifested as subcutaneous nodules without epidermal involvement within the axis of lymphatic drainage toward the regional lymph node, at times accompanied by regional lymphadenopathy. In all patients, the lymphatic dissemination was not present at initial diagnosis of CL, appearing only after local (topical or intralesional) treatment was initiated. In three patients, the subcutaneous nodules resolved without systemic treatment. Lymphatic dissemination of Old World CL is not uncommon and may possibly be triggered by local treatment. It should be recognized by dermatologists, especially those working in endemic areas. Systemic treatment may be not necessary since spontaneous resolution may occur.

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/content/journals/10.4269/ajtmh.14-0787
2015-10-07
2017-09-23
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References

  1. Bari AU, , 2012. Clinical spectrum of cutaneous leishmaniasis: an overview from Pakistan. Dermatol Online J 18: 4.
  2. Burden-Teh E, Wooton CI, Williams HC, , 2015. Can a simple outpatient-based treatment be used to treat cutaneous leishmaniasis in young children? A critically appraised topic. Br J Dermatol 172: 861866.
  3. Solomon M, Pavlotsky F, Leshem E, Ephros M, Trau H, Schwartz E, , 2011. Liposomal amphotericin B treatment of cutaneous leishmaniasis due to Leishmania tropica. J Eur Acad Dermatol Venereol 25: 973977.
  4. Bailey MS, Caddy AJ, McKinnon KA, Fogg LF, Roscoe M, Bailey JW, O'Dempsey TJ, Beeching NJ, , 2012. Outbreak of zoonotic cutaneous leishmaniasis with local dissemination in Balkh, Afghanistan. J R Army Med Corps 158: 225228.
  5. Kibbi AG, Karam PG, Kurban AK, , 1987. Sporotrichoid leishmaniasis in patients from Saudi Arabia: clinical and histologic features. J Am Acad Dermatol 17: 759764.
  6. Masmoudi A, Ayadi N, Khabir A, Bouzid L, Bouassida S, Meziou TJ, Akrout F, Zahaf A, Boudawara T, Turki H, , 2008. Sporotrichoid cutaneous leishmaniasis in Tunisia: a clinical and histological study. Ann Dermatol Venereol 135: 6367.
  7. Kubba R, El Hassan AM, Al Gindan Y, Omer AHS, Kutty MK, Saeed MBM, , 1987. Dissemination in cutaneous leishmaniasis. I. Subcutaneous nodules. Int J Dermatol 26: 300304.
  8. Schonian G, Nasereddin A, Dinse N, Schweynoch C, Schallig HD, Presber W, Jaffe CL, , 2003. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis 47: 349358.
  9. Akilov OE, Khachemoune A, Hasan T, , 2007. Clinical manifestations and classification of Old World cutaneous leishmaniasis. Int J Dermatol 46: 132142.
  10. Najim RA, Sharquie KE, Al-Zubaidy SA, , 2006. Possible mechanisms of action of the compounds injected intralesionally in the treatment of cutaneous leishmaniasis, in addition to their direct effects on the parasites. Ann Trop Med Parasitol 100: 3338.
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  • Received : 07 Dec 2014
  • Accepted : 19 Jun 2015

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