Cutaneous leishmaniosis presented pathologically as pyoderma

Introduction:The leishmaniases are visceral, cutaneous and mucosal infections transmitted by sandfliesand caused by the genus Leishmania. Lesions of cutaneous leishmania (CL) usually starts aserythamatous papules, gradually enlarges 1-2 cm in diameter in about 6 months and ulcerates.Ulcers are painless with a necrotic base and indurated margin covered by a firmly adherentcrust.Case presentation:A 78-year-old woman was referred to hospital with chronic large ulcers with some clinicalfeatures of pyoderma in her right leg. She had these ulcers from 4 months ago with no historyof fever, weight loss, or any systemic diseases. Physical examination revealed large painlessulcers with necrotic surface and pustular or erythematous border on his leg. A biopsy hadbeen taken with clinical impression of pyoderma gangronosum 2 month earlier. According tolarge area of pyoderma the clinical suggestion had been approved and patient had receivedimmunosuppressive therapy for treatment of pyoderma gangronosum but the lesion had beenworsened after that. The second biopsy was taken and revealed large area of necrosis andpyoderma with a rim of leishman body-laden macrophages. Re-evaluation of first biopsyshowed scattered macrophages in the periphery of necrotic area with less numbers ofparasites than recent biopsy.Discussion:There are many pathologic features for CL. Focal or diffuse necrosis with or without typicalgranuloma and variable numbers of parasitized macrophages are seen in CL. It is important tokeep CL as one of the etiologies of pyoderma in mind and search specimen carefully forsmall numbers of parasites.

کلیدواژه ها:

leishmaniosis ، pyoderma