Am J Trop Med Hyg. 2021 May 10;105(1):134-137. doi: 10.4269/ajtmh.20-0595.
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.
皮肤利什曼病是最常见的利什曼病形式，典型表现为小的红斑丘疹和结节，发展为硬结、隆起的边缘的溃疡。然而，皮肤利什曼病的病变可能具有多形性和非典型表现。类丹毒样型是皮肤利什曼病的罕见非典型表现之一。报告了一例来自尼泊尔山区的 58 岁男性病例，他在左肘前窝出现非典型红斑和水肿斑块。由于病变的非典型外观以及他居住在尼泊尔山区，最初并未考虑皮肤利什曼病的诊断。在对皮肤活检标本进行组织病理学检查发现无鞭毛体后做出诊断。口服米替福新和随后口服氟康唑治疗后，病变完全消退。临床医生应注意皮肤利什曼病的非典型表现，无论表现如何或地理位置如何，都应将其纳入鉴别诊断。
