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CASE REPORT   

Giornale Italiano di Dermatologia e Venereologia 1999 June;134(3):227-31

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Atypical cutaneous leishmaniasis. A case report

Spagnuolo A. 1, Astorino S. 1, Innocenzi D. 2, Gradoni L. 3

1 Policlinico Militare - Roma, Reparto Dermatologia; 2 Università degli Studi di Roma, «La Sapienza» - Roma, Istituto di Clinica Dermatologica; 3 Istituto Superiore di Sanità, Laboratorio di Parassitologia


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The case of a 60-years-old man, affected by multiple papulo-nodular, erythematous-yellowish, infiltered lesions, developping progressively in centripetal way on his right hand and fore-arm for nearly two months, is described. The histological analysis of one lesion showed the typical picture of cutaneous leishmaniasis. The anamnesis showed recent travels in the Far and Middle East, and in North Africa. Isoenzymatic typing, however, highlighted a type of zymodeme Montpellier 78 of L. Infantum, found in Sicily and in Malta’s islands so far, and known as an agent of cutaneous leishmaniasis or visceral leishmaniasis in HIV-positive subjects. Attention is focused on the peculiarity of some clinical features of this case, as “keloidal” morphology of lesions, large number of elements and their development and “pseudo-sporothricoidal” disposition along the superficial lymphatic vessels. It is very important to underline the rarity of this zymodeme, which restricts the origin of infection to the Mediterranean area. Finally, attention is drawn to the use of cryotherapy in our patient’s treatment, making a comparison with other possible therapies for cutaneous leishmaniasis.

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