• 1.

    Burza S, Croft SL, Boelaert M, 2018. Leishmaniasis. Lancet 392: 951970.

  • 2.

    Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA, 2015. Cutaneous and mucocutaneous leishmaniasis: clinical perspectives. J Am Acad Dermatol 73: 897908.

    • Search Google Scholar
    • Export Citation
  • 3.

    World Health Organization, 2020. Leishmaniasis. Geneva, Switzerland: WHO. Available at: https://www.who.int/en/news-room/fact-sheets/detail/leishmaniasis. Accessed April 29, 2021.

  • 4.

    Alemayehu B, Alemayehu M, 2017. Leishmaniasis: a review on parasite, vector and reservoir host. Health Sci J 11: 519.

  • 5.

    Kevric I, Cappel MA, Keeling JH, 2015. New World and Old World Leishmania infections: a practical review. Dermatol Clin 33: 579593.

  • 6.

    Meireles CB, Maia LC, Soares GC, Teodoro IPP, Gadelha MDSV, da Silva CGL, de Lima MAP, 2017. Atypical presentations of cutaneous leishmaniasis: a systematic review. Acta Trop 172: 240254.

    • Search Google Scholar
    • Export Citation
  • 7.

    Kumar R, Ansari NA, Avninder S, Ramesh V, Salotra P, 2008. Cutaneous leishmaniasis in Nepal: Leishmania major as a cause. Trans R Soc Trop Med Hyg 102: 202203.

    • Search Google Scholar
    • Export Citation
  • 8.

    Bastola A 2020. A case of high altitude cutaneous leishmaniasis in a non-endemic region in Nepal. Parasitol Int 74: 101991.

  • 9.

    Parija SC, Jacob M, Karki BM, Sethi M, Karki P, Koirala S, 1998. Cutaneous leishmaniasis in Nepal. Southeast Asian J Trop Med Public Health 29: 131132.

    • Search Google Scholar
    • Export Citation
  • 10.

    World Health Organization, 2021. Leishmaniasis. Geneva, Switzerland: WHO. Available at: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/leishmaniasis. Accessed April 29, 2021.

  • 11.

    World Health Organization, 2021. Leishmaniasis. Geneva, Switzerland: WHO. Available at: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/status-of-endemicity-of-visceral-leishmaniasis. Accessed April 29, 2021.

  • 12.

    World Health Organization, 2021. Leishmaniasis. Geneva, Switzerland: WHO. Available at: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/status-of-endemicity-of-cutaneous-leishmaniasis. Accessed April 29, 2021.

  • 13.

    World Health Organization, 2021. Leishmaniasis. Geneva, Switzerland: WHO. Available at: https://apps.who.int/neglected_diseases/ntddata/leishmaniasis/leishmaniasis.html. Accessed April 29, 2021.

  • 14.

    Karki P, Parija SC, George S, Das ML, Koirala S, 1997. Visceral leishmaniasis with cutaneous ulcer or cutaneous leishmaniasis in Nepal. Southeast Asian J Trop Med Public Health 28: 836837.

    • Search Google Scholar
    • Export Citation
  • 15.

    Pandey BD, Babu E, Thapa S, Thapa LB, 2006. First case of cutaneous leishmaniasis in Nepalese patient. Nepal Med Coll J 8: 213214.

  • 16.

    Neupane S, Sharma P, Kumar A, Paudel U, Pokhrel DB, 2008. Cutaneous leishmaniasis: report of rare cases in Nepal. Nepal Med Coll J 10: 6467.

  • 17.

    Paudel U, Parajuli S, Poudel AS, Paudel V, Pokhrel DB, 2019. Cutaneous leishmaniasis in natives of central region of Nepal. Kathmandu Univ Med J 65: 7779.

    • Search Google Scholar
    • Export Citation
  • 18.

    Ghimire P, Shrestha R, Pandey S, Pokhrel K, Pande R, 2018. Cutaneous leishmaniasis: a neglected vector borne tropical disease in midwestern region of Nepal. Nepal J Dermatol Venereol Leprol 16: 4144.

    • Search Google Scholar
    • Export Citation
  • 19.

    Paudel V, Parajuli S, Chudal D, 2020. Cutaneous leishmaniasis in Nepal: an emerging public health concern. Our Dermatol Online 11: 7678.

  • 20.

    Parajuli N, Adhikary S, Karki A, Tiwari S, 2021. Case report: erysipeloid cutaneous leishmaniasis treated with oral miltefosine. Am J Trop Med Hyg 104: 643–645.

    • Search Google Scholar
    • Export Citation
  • 21.

    Ozdemir M, Cimen K, Mevlitoglu I, 2007. Post-traumatic erysipeloid cutaneous leishmaniasis. Int J Dermatol 46: 12921293.

  • 22.

    Bongiorno MR, Pistone G, Aricò M, 2009. Unusual clinical variants of cutaneous leishmaniasis in Sicily. Int J Dermatol 48: 286289.

  • 23.

    Karincaoglu Y, Esrefoglu M, Ozcan H, 2004. Atypical clinical form of cutaneous leishmaniasis: erysipeloid form. Int J Dermatol 43: 827829.

  • 24.

    Mnejja M, Hammami B, Chakroun A, Achour I, Charfeddine I, Chakroun A, Turki H, Ghorbel A, 2011. Unusual form of cutaneous leishmaniasis: erysipeloid form. Eur Ann Otorhinolaryngol Head Neck Dis 128: 9597.

    • Search Google Scholar
    • Export Citation
  • 25.

    Akilov OE, Khachemoune A, Hasan T, 2007. Clinical manifestations and classification of Old World cutaneous leishmaniasis. Int J Dermatol 46: 132142.

    • Search Google Scholar
    • Export Citation
  • 26.

    Remadi L, Haouas N, Chaara D, Slama D, Chargui N, Dabghi R, Jbeniani H, Mezhoud H, Babba H, 2016. Clinical presentation of cutaneous leishmaniasis caused by Leishmania major. Dermatology 232: 752759.

    • Search Google Scholar
    • Export Citation
  • 27.

    Shrestha M, Pandey BD, Maharjan J, Dumre SP, Tiwari PN, Manandhar KD, Pun SB, Pandey K, 2018. Visceral leishmaniasis from a non-endemic Himalayan region of Nepal. Parasitol Res 117: 23232326.

    • Search Google Scholar
    • Export Citation
  • 28.

    Department of Health Services, Ministry of Health and Population, Government of Nepal, 2019. National Guideline on Kala-Azar Elimination Program (Updated) 2019. Available at: http://www.edcd.gov.np/resources/download/national-guideline-on-kala-azar-elimination-program-2019. Accessed January 18, 2021.

  • 29.

    World Health Organization, 2014. Manual for Case Management of Cutaneous Leishmaniasis in the WHO Eastern Mediterranean Region. WHO Regional Publications, Eastern Mediterranean Series. Geneva, Switzerland: WHO.

  • 30.

    Monge-Maillo B, López-Vélez R, 2015. Miltefosine for visceral and cutaneous leishmaniasis: drug characteristics and evidence-based treatment recommendations. Clin Infect Dis 60: 13981404.

    • Search Google Scholar
    • Export Citation
  • 31.

    Mosimann V, Blazek C, Grob H, Chaney M, Neumayr A, Blum J, 2016. Miltefosine for mucosal and complicated cutaneous Old World leishmaniasis: a case series and review of the literature. Open Forum Infect Dis 3: ofw008.

    • Search Google Scholar
    • Export Citation
  • 32.

    Dorlo TP, van Thiel PP, Huitema AD, Keizer RJ, de Vries HJ, Beijnen JH, de Vries PJ, 2008. Pharmacokinetics of miltefosine in Old World cutaneous leishmaniasis patients. Antimicrob Agents Chemother 52: 28552860.

    • Search Google Scholar
    • Export Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Report: An Atypical Erysipeloid Presentation of Cutaneous Leishmaniasis from the Hilly Region of Nepal

View More View Less
  • 1 Helping Hands Community Hospital, Kathmandu, Nepal

Abstract.

Cutaneous leishmaniasis, which is the most common form of leishmaniasis, classically presents as small erythematous papules and nodules that develop into ulcers with indurated, raised outer borders. However, lesions of cutaneous leishmaniasis can have pleomorphic and atypical presentations. The erysipeloid form is one of the rare, atypical presentations of cutaneous leishmaniasis. Reported is a case of a 58-year-old man from the hilly region of Nepal who presented with an atypical erythematous and edematous plaque over the left antecubital fossa. Cutaneous leishmaniasis was not considered as an initial diagnosis because of the atypical appearance of the lesion as well as his residence in the hilly region of Nepal. The diagnosis was made after detection of amastigotes on histopathological examination of a cutaneous biopsy specimen. There was complete regression of the lesion after treatment with oral miltefosine followed by oral fluconazole. Clinicians should be aware of atypical presentations of cutaneous leishmaniasis and it should be considered in the differential diagnosis, regardless of the presentation or geographic location.

Author Notes

Address correspondence to Suman Nepal, Helping Hands Community Hospital, Chabahil 44602, Kathmandu, Nepal. E-mail: nepalsuman7@gmail.com

Author’s address: Suman Nepal, Helping Hands Community Hospital, Chabahil 44602, Kathmandu, Nepal, E-mail: nepalsuman7@gmail.com.

Save