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Reprint Address: Fred Bernardes Filho, md, Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo. Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, Brazil
Affiliations
Emergency Department, Hospital Imaculada Conceição da Sociedade Portuguesa de Beneficência, Ribeirão Preto, São Paulo, BrazilDermatology Division, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
Department of Radiology and Imaging, Santa Casa da Misericórdia of Avaré, Avaré, São Paulo, BrazilCENTROMED Diagnóstico por Imagem, Avaré, São Paulo, Brazil
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.
Figure 1Painless circular ulcers with infiltrated frame-like borders on right forearm and
left pectoral region, ellipticalerosion located on the mid-lower lip, and ulcerative
chronic paronychia like lesion on the fifth left finger.
Final diagnosis of 86 cases included in differential diagnosis of American tegumentary leishmaniasis in a Brazilian sample: a retrospective cross-sectional study.
