Department of Dermatology, Şanlıurfa Training and Research Hospital, Yenice Road, Yenice, Şanlıurfa 63000, Turkey.
Department of Medical Microbiology, Harran University Medical Faculty, Şanlıurfa 63000, Turkey.
Postgrad Med J. 2024 Sep 22;100(1188):760-768. doi: 10.1093/postmj/qgae075.
Our objective in this study is to determine the atypical clinical presentations of cutaneous leishmaniasis (CL) patients diagnosed in Şanlıurfa province.
This retrospective study included 213 patients with atypical clinical presentations among 1751 patients diagnosed with CL between October 2019 and August 2022 in Şanlıurfa Oriental Boil Diagnosis and Treatment Center located in an endemic region for CL.
We found the prevalence of atypical CL to be 12.1%. The most common atypical lesions were lupoid 21 (9.8%), erysipeloid 16 (7.5%), impetiginous 16 (7.5%), recidivan 15 (7%), eczematous 15 (7%), ecthyma-like 13 (6.1%), pyoderma gangrenous-like 12 (5.6%), and sporotrichoid 12 (5.6%). Other lesions with atypical clinical presentations: chalazion-like, verrucous, dental sinus-like, psoriasiform, zosteriform, lymphoma-like, juvenile xanthogranuloma-like, volcano-like, paronychial, basal cell carcinoma-like, squamous cell carcinoma-like, herpes labialis-like, keratoacanthoma-like, chancriform, annular, lichenoid, mastocitoma-like, keloidal, epidermoid cyst-like, kaposi sarcoma-like, scar leishmaniasis, granulomatous cheilitis-like, mycetoma-like, molluscum contagiosum-like, discoid lupus erythematosus-like, and dermatofibroma-like.
In addition to the atypical clinical presentations previously reported, we also defined dermatofibroma-like, Kaposi sarcoma-like, dental sinus-like, juvenile xanthogranuloma-like, mastocytoma-like, and epidermoid cyst-like. It should be kept in mind that CL can clinically mimic many infectious, inflammatory, and neoplastic diseases, which should be considered in the differential diagnosis of long-term non-healing lesions, especially in endemic areas. Key message What is already known on this subject: CL is known as the great imitator disease in dermatology. What this study adds: In addition to the atypical clinical presentations previously reported, we also defined dermatofibroma-like, Kaposi sarcoma-like, dental sinus-like, juvenile xanthogranuloma-like, mastocytoma-like, and epidermoid cyst-like. How this study might affect research, practice, or policy: CL can clinically mimic many infectious, inflammatory and neoplastic diseases, which should be considered in the differential diagnosis of long-term non-healing lesions, especially in endemic areas.
本研究旨在确定在Şanlıurfa 省诊断为皮肤利什曼病（CL）的患者的非典型临床表现。
本回顾性研究纳入了 2019 年 10 月至 2022 年 8 月期间在Şanlıurfa 东方疖子诊断和治疗中心（该地区为 CL 的流行区）诊断为 CL 的 1751 例患者中 213 例具有非典型临床表现的患者。
我们发现非典型 CL 的患病率为 12.1%。最常见的非典型病变是狼疮样 21 例（9.8%）、类丹毒样 16 例（7.5%）、脓疱疮样 16 例（7.5%）、复发性 15 例（7%）、湿疹样 15 例（7%）、类天疱疮样 15 例（7%）、类坏疽性脓疱疮样 12 例（5.6%）和孢子丝菌病样 12 例（5.6%）。其他具有非典型临床表现的病变包括：睑腺炎样、疣状、牙窦样、银屑病样、带状疱疹样、淋巴瘤样、幼年黄色肉芽肿样、火山样、甲周样、基底细胞癌样、鳞状细胞癌样、唇疱疹样、角化棘皮瘤样、坏疽性、环状、苔藓样、肥大细胞瘤样、瘢痕疙瘩样、表皮样囊肿样、卡波西肉瘤样、瘢痕性利什曼病、类肉芽肿性唇炎样、放线菌病样、传染性软疣样、盘状红斑狼疮样和皮肤纤维瘤样。
除了之前报道的非典型临床表现外，我们还定义了皮肤纤维瘤样、卡波西肉瘤样、牙窦样、幼年黄色肉芽肿样、肥大细胞瘤样和表皮样囊肿样。应牢记，CL 在临床上可模拟许多感染性、炎症性和肿瘤性疾病，尤其是在流行地区，应在长期不愈合病变的鉴别诊断中考虑这些疾病。
本研究主题已知信息：CL 在皮肤病学中被称为模仿大师疾病。本研究新增信息：除了之前报道的非典型临床表现外，我们还定义了皮肤纤维瘤样、卡波西肉瘤样、牙窦样、幼年黄色肉芽肿样、肥大细胞瘤样和表皮样囊肿样。本研究可能对研究、实践或政策产生的影响：CL 在临床上可模拟许多感染性、炎症性和肿瘤性疾病，尤其是在流行地区，应在长期不愈合病变的鉴别诊断中考虑这些疾病。
