Cutaneous and Mucocutaneous Leishmaniasis Resembling
Borderline-tuberculoid Leprosy: A New Clinical Presentation?
Federica Dassoni1, Zerihun Abebe2, Bernard Naafs3 and Aldo Morrone1
1National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy, 2Ayder Referral Hospital of Mekele University, Mekele, Ethiopia, and 3Stichting
Tropen Dermatologie, Munnekeburen, The Netherlands
Both cutaneous and mucocutaneous leishmaniasis are
endemic in Northern Ethiopia. The different clinical presentations
depend on the responsible organism and the
host?s immune response. Localized cutaneous leishmaniasis
is the type most frequently seen. Diffuse cutaneous
leishmaniasis is relatively rare and usually associated
with mucous membrane involvement. Diffuse cutaneous
leishmaniasis presents with multiple lesions, can be difficult
to diagnose and responds less favourably to treatment.
We report here 2 patients with unusual presentations
of diffuse cutaneous leishmaniasis presenting with
large hypopigmented skin lesions mimicking borderlinetuberculoid
leprosy. To our knowledge this presentation
has not been described before and may present difficulties
in making a definite diagnosis in regions where both
leprosy and cutaneous leishmaniasis are endemic. Lepromatous
leprosy and diffuse cutaneous leishmaniasis are
regularly confused, particularly when no skin smears
for acid-fast bacillus or Leishman-Donovan bodies are
performed. Key words: leishmaniasis; leprosy; hypopigmentation.
Accepted December 6, 2011.
Acta Derm Venereol 2012; 92: XX?XX
Discussion
Leishmaniasis is one of the top 5 diseases targeted by
the World Health Organization (WHO) Special Program
for Research and Training in Tropical Diseases.
Approximately 1.5 million new cases are documented
each year and more than 350 million people live in
areas of active parasite transmission.
Clinically, localized cutaneous lesions may resemble
other skin conditions; blastomycosis, sporotrichosis,
cutaneous anthrax, eczema, fungal skin infections,
lepromatous leprosy, Mycobacterium marinum infections,
sarcoidosis, basal and squamous cell carcinomas,
tuberculosis and infected insect bites. When the plaque
lesions of CL are located on the face: systemic lupus erythematosus,
discoid lupus erythematosus, sarcoidosis,
lupus vulgaris, cutaneous lymphoma and erysipelas are
in the differential diagnosis....
