Masmoudi A, Ayadi N, Bouassida S, Khabir A, Akrout F, Boudayara T, Turki H, Zahaf A
Service de dermatologie et de vénéréologie, CHU Hédi-Chaker, Sfax, Tunisie.
Bull Soc Pathol Exot. 2008 Dec;101(5):395-7. doi: 10.3185/pathexo2865.
The erysipeloid form of cutaneous leishmaniasis is considered as an unusual and rare clinical presentation in Tunisia. Our prospective study on 4 observations, aimed at examining the clinical, histological and progressive features of the "erysipeloid" form of cutaneous leishmaniasis. Our patients were 3 females and one male more than 62 years old. Their cutaneous leishmaniasis was clinically characterised by an infiltrated and extensive plaque which was localised on the face covering the nose and cheeks looking like erysipelas. The treatment was intramuscular meglumine antimoniate (Glucantime) in three cases and metronidazole in one case. A regression without scar was noticed in all the cases. On the histological examination, we observed an intense epidermic and constant hyperplasia with presence of amastigotes in 3 cases. Our study shows the lesional polymorphism of the old word cutaneous leishmaniasis in our region. The "erysipeloid" form of cutaneous leishmaniasis is a rare clinical presentation which generally affects women. If the clinical aspect is very meaningful, the histological aspect is meaningful but not specific.
皮肤利什曼病的类丹毒形式在突尼斯被认为是一种不寻常且罕见的临床表现。我们对4例病例进行的前瞻性研究,旨在探讨皮肤利什曼病“类丹毒”形式的临床、组织学及进展特征。我们的患者为3名女性和1名62岁以上男性。他们的皮肤利什曼病临床特征为浸润性广泛斑块,位于面部,覆盖鼻子和脸颊,类似丹毒。3例患者接受肌肉注射葡甲胺锑酸盐(葡糖胺锑)治疗,1例接受甲硝唑治疗。所有病例均出现无瘢痕消退。组织学检查时,3例观察到强烈的表皮增生且持续存在无鞭毛体。我们的研究显示了我们地区旧大陆皮肤利什曼病的损害多态性。皮肤利什曼病的“类丹毒”形式是一种罕见的临床表现,通常影响女性。如果临床方面非常有意义,那么组织学方面虽有意义但不具特异性。