A 49-year-old male patient, alcoholic, smoker, and cocaine user presented with a 3-month history of mucocutaneous ulcers. He was facing psychological, social, and behavioral consequences brought about by the lesions' repulsive features. Positive findings on physical examination included two skin ulcers with raised indurated border, an ulcerovegetative lesion on the lower lip, and an erythematous ill-defined plaque on the fifth left finger with onycholysis (Figure 1). Histopathology showed dense inflammatory infiltrate consisting of plasma cells, lymphocytes, and macrophages, presenting formation of epithelioid cell granulomas with frequent multinucleated giant cells. Polymerase chain reaction was positive for Leishmania spp (Figure 2). The patient was treated with meglumine antimoniate, 20 mg/Kg/day for 30 days. He responded well to treatment, with no reactivation during follow-up.
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Published online: March 07, 2018
Accepted: February 6, 2018
Received: January 27, 2018
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