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      • Record: found
      • Abstract: found
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      Chronic Skin Lesions as the Presentation of Diffuse Cutaneous Leishmaniasis in the HIV-Infected Woman: A Case Report and Review of Literatures

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          Abstract

          Background:

          Cutaneous leishmaniasis (CL) is the most form of leishmaniasis that caused by intracellular parasites, Leishmania.

          Case Report:

          A 39-year-old woman, known case of HIV infection, presented with a 6-month history of skin lesions initially on her face, then extending onto the chest, abdomen, and extremities. Laboratory examinations revealed leukopenia and a CD4 cell count of 280 cells / mm3. A biopsy was taken from skin lesions, and histopathological studies showed aggregates of macrophages filled with numerous Leishman bodies, the diagnosis of diffuse CL was confirmed. Consequently, she received liposomal amphotericin B (total dose of 40 mg/kg) as a case of diffuse CL. The skin lesions showed significant improvement after completion of treatment.

          Conclusion:

          Diffuse CL should be considered as a differential diagnosis in all patients with diffuse skin lesions mainly in the cases that suffer from disorders of cell-mediated immunity.

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          Most cited references10

          • Record: found
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          The history of leishmaniasis

          Dietmar Steverding (2017)
          In this review article the history of leishmaniasis is discussed regarding the origin of the genus Leishmania in the Mesozoic era and its subsequent geographical distribution, initial evidence of the disease in ancient times, first accounts of the infection in the Middle Ages, and the discovery of Leishmania parasites as causative agents of leishmaniasis in modern times. With respect to the origin and dispersal of Leishmania parasites, the three currently debated hypotheses (Palaearctic, Neotropical and supercontinental origin, respectively) are presented. Ancient documents and paleoparasitological data indicate that leishmaniasis was already widespread in antiquity. Identification of Leishmania parasites as etiological agents and sand flies as the transmission vectors of leishmaniasis started at the beginning of the 20th century and the discovery of new Leishmania and sand fly species continued well into the 21st century. Lately, the Syrian civil war and refugee crises have shown that leishmaniasis epidemics can happen any time in conflict areas and neighbouring regions where the disease was previously endemic.
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            Arginase I, polyamine, and prostaglandin E2 pathways suppress the inflammatory response and contribute to diffuse cutaneous leishmaniasis.

            Jaqueline França-Costa, Johan Van Weyenbergh, Viviane Boaventura … (2015)
            Diffuse cutaneous leishmaniasis (DCL) is a rare clinical manifestation of tegumentary leishmaniasis. The molecular mechanisms underlying DCL pathogenesis remain unclear, and there is no efficient treatment available. This study investigated the systemic and in situ expression of the inflammatory response that might contribute to suppression in DCL. The plasma levels of arginase I, ornithine decarboxylase (ODC), transforming growth factor β (TGF-β), and prostaglandin E2 (PGE2) were higher in patients with DCL, compared with patients with localized cutaneous leishmaniasis (LCL) or with controls from an area of endemicity. In situ transcriptomic analyses reinforced the association between arginase I expression and enzymes involved in prostaglandin and polyamine synthesis. Immunohistochemistry confirmed that arginase I, ODC, and cyclooxygenase2 expression was higher in lesion biopsy specimens from patients with DCL than in those from patients with LCL. Inhibition of arginase I or ODC abrogates L. amazonensis replication in infected human macrophages. Our data implicate arginase I, ODC, PGE2, and TGF-β in the failure to mount an efficient immune response and suggest perspectives in the development of new strategies for therapeutic intervention for patients with DCL.
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              Isolation of Leishmania tropica from a patient with visceral leishmaniasis and disseminated cutaneous leishmaniasis, southern Iran.

              Gholam R Pouladfar, M R Kadivar, Mahdi Fakhar … (2008)
              We report a case visceral leishmaniasis with disseminated cutaneous leishmaniasis caused by Leishmania tropica in southern Iran. Typing of this parasite was performed by a species-specific polymerase chain reaction and isoenzyme electrophoresis.
              Article 0 comments Cited 23 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Galen Med J
                Journal ID (iso-abbrev): Galen Med J
                Journal ID (publisher-id): Galen Medical Journal
                Journal ID (pmc): Galen Medical Journal
                Journal ID (publisher-id): gmj
                Title: Galen Medical Journal
                Publisher: Salvia Medical Sciences Ltd
                ISSN (Print): 2588-2767
                ISSN (Electronic): 2322-2379
                Publication date Collection: 2019
                Publication date (Electronic): 1 January 2019
                Volume: 8
                Page: e1294
                Affiliations
                1Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
                2Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
                3Department Of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
                4Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
                5Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
                Author notes
                [* ] Correspondence to: Behnam Dalfardi, MD, Internal Medicine Resident, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Telephone Number: 0098-71-32122970 Email Address: Dalfardibeh@ 123456gmail.com
                Article
                DOI: 10.31661/gmj.v8i0.1294
                PMC ID: 8343584
                SO-VID: f800c2b9-cd83-4d65-aad1-1eb578958571
                Copyright © Copyright© 2019, Galen Medical Journal.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/)

                History
                Date received : 20 July 2018
                Date revision received : 07 September 2018
                Date accepted : 14 October 2018
                Page count
                Figures: 2, References: 10, Pages: 4
                Categories
                Subject: Case Report

                Keywords: hiv,infectious disease medicine,leishmaniasis,skin diseases
                Data availability:
                Keywords: hiv, infectious disease medicine, leishmaniasis, skin diseases

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