Chahboun Fatimazahra, Eljazouly Madiha, Alj Maha, Chiheb Soumiya
Dermatology Unit, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, MAR.
Cureus. 2022 Mar 4;14(3):e22836. doi: 10.7759/cureus.22836. eCollection 2022 Mar.
Cutaneous leishmaniasis is a parasitic infection characterized by a high clinical polymorphism. Unusual clinical aspects have been reported in immunodeficient patients or associated with particular parasite species. This is the case report of a 36-year-old man with a history of type 1 diabetes who presented with a verrous plaque on the dorsal aspect of the fourth finger of the left hand, which appeared six months after traveling to southern Morocco. It was a papulo-nodular verrucous lesion, and was nonpruritic and nonpainful, with a keratotic surface, which had been progressively increasing in volume. A skin biopsy was performed, which showed evidence of leishmaniasis bodies after specific staining (May-Grünwald Giemsa stain). The patient was treated for eight weeks with weekly intralesional injections of meglumine antimoniate (Glucantime) and touch-ups with trichloroacetic acid (TCA) 20%. The evolution was marked by a clear regression of the lesion after four months. Herein, we describe a particular clinical aspect of cutaneous leishmaniasis: the verrucous form. This is a rare presentation that suggests the role of factors related to parasite species and/or diabetes. The combination of TCA with meglumine antimonate is a promising treatment option.
皮肤利什曼病是一种具有高度临床多态性的寄生虫感染。免疫缺陷患者或与特定寄生虫种类相关的患者中曾报告过不寻常的临床症状。本文报告一例36岁男性病例，该患者有1型糖尿病病史，左手无名指背侧出现一个疣状斑块，此症状在其前往摩洛哥南部旅行6个月后出现。这是一个丘疹结节性疣状病变，无瘙痒和疼痛，表面有角化，体积逐渐增大。进行了皮肤活检，经特异性染色（May-Grünwald Giemsa染色）后显示有利什曼病小体的证据。患者接受了为期8周的治疗，每周进行一次病灶内注射葡甲胺锑酸盐（葡糖胺锑，Glucantime），并用20%的三氯乙酸（TCA）进行修补。4个月后病变明显消退，病情好转。在此，我们描述了皮肤利什曼病的一种特殊临床症状：疣状形式。这是一种罕见的表现，提示了与寄生虫种类和/或糖尿病相关的因素的作用。三氯乙酸与葡甲胺锑酸盐联合使用是一种有前景的治疗选择。
