Verma G K, Verma Santwana, Shanker Vinay, Singh Gagandeep, Tegta G R
Department of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
Trop Doct. 2012 Oct;42(4):237-9. doi: 10.1258/td.2012.120316. Epub 2012 Nov 8.
Diffuse cutaneous leishmaniasis (DCL) is a rare variant of cutaneous leishmaniasis (CL) characterised by multiple (≥10), widespread, slowly progressive, cosmetically disfiguring, non-ulcerating nodules without visceral involvement. The disease is resistant to chemotherapy and characterized by relapses. We present a rare case of a patient with DCL who had extensive lesions (282) and who was HIV negative from a new focus of leishmaniasis in sub-Himalayan India. A favourable response with a regression of the lesions was observed after a month of treatment with intravenous and intralesional sodium stibogluconate with oral pentoxiphyline. Familiarity with such exceptional cases in immunocompetent individuals may facilitate diagnosis and a promising treatment outcome.
弥漫性皮肤利什曼病(DCL)是皮肤利什曼病(CL)的一种罕见变体,其特征为多个(≥10个)、广泛分布、进展缓慢、有美容缺陷、无溃疡的结节,且无内脏受累。该疾病对化疗耐药且易复发。我们报告了一例罕见的DCL患者,该患者有广泛病变(282处),且来自印度喜马拉雅山地区一个新的利什曼病疫源地,HIV检测为阴性。在用静脉内和病灶内注射葡萄糖酸锑钠及口服己酮可可碱治疗一个月后,观察到病变消退,反应良好。熟悉免疫功能正常个体中的此类特殊病例可能有助于诊断并取得有希望的治疗结果。