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Disseminated Cutaneous Leishmaniasis in Colombia: Report of 27 Cases.

Vélez ID, Jiménez A, Vásquez D, Robledo SM - Case Rep Dermatol (2015)

Bottom Line: Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia) panamensis was identified as the causative agent in 58% of cases.Eighteen patients recovered with pentavalent antimonial.The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis.

View Article: PubMed Central - PubMed

Affiliation: PECET, Medical Research Institute, School of Medicine, University of Antioquia UdeA, Medellín, Colombia.

ABSTRACT
Disseminated leishmaniasis (DL) is a poorly described disease that is frequently misdiagnosed as other clinical manifestations of cutaneous leishmaniasis (CL) such as diffuse CL or post-kala-azar dermal leishmaniasis. Twenty-seven cases of DL diagnosed between 1997 and 2015 are described. A higher prevalence was observed in men (mean age 32 years). The number of lesions per patient ranged from 12 to 294, distributed mainly in the upper extremities, face and trunk. The lesions were mostly plaques or nodules. Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia) panamensis was identified as the causative agent in 58% of cases. Eighteen patients recovered with pentavalent antimonial. The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis.

No MeSH data available.


Related in: MedlinePlus

Male with 250 lesions. This patient was treated with intramuscular meglumine antimoniate. After failure, the patient was treated with miltefosine and was cured. Lesions before (a–c) and after treatment (d–f).
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Figure 2: Male with 250 lesions. This patient was treated with intramuscular meglumine antimoniate. After failure, the patient was treated with miltefosine and was cured. Lesions before (a–c) and after treatment (d–f).

Mentions: All patients met the diagnostic criteria of having 10 or more polymorphic lesions in at least 2 parts of the body surface. The number of lesions for each patient varied between 12 and 294 (21 patients with 100 lesions or less, 3 patients had more than 100 lesions and less than 200, and 4 patients had more than 200 lesions; table 3). The evolution time since the appearance of the first lesion to the spreading was more than 2 weeks. In most patients, the primary lesion was plaque, and the secondary lesions (disseminated) were nodules, papules and plaques, with different sizes but smaller than 2.0 cm in diameter. Only 1 patient had frank ulcers (fig. 1, fig. 2, fig. 3, fig. 4). Lesions were present mainly on the face, trunk and upper limbs. Seven patients (25%) had nasal mucosal involvement consisting of ulcers, scabs or septal perforation indicating an important frequency of mucosal involvement.


Disseminated Cutaneous Leishmaniasis in Colombia: Report of 27 Cases.

Vélez ID, Jiménez A, Vásquez D, Robledo SM - Case Rep Dermatol (2015)

Male with 250 lesions. This patient was treated with intramuscular meglumine antimoniate. After failure, the patient was treated with miltefosine and was cured. Lesions before (a–c) and after treatment (d–f).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4637797&req=5

Figure 2: Male with 250 lesions. This patient was treated with intramuscular meglumine antimoniate. After failure, the patient was treated with miltefosine and was cured. Lesions before (a–c) and after treatment (d–f).
Mentions: All patients met the diagnostic criteria of having 10 or more polymorphic lesions in at least 2 parts of the body surface. The number of lesions for each patient varied between 12 and 294 (21 patients with 100 lesions or less, 3 patients had more than 100 lesions and less than 200, and 4 patients had more than 200 lesions; table 3). The evolution time since the appearance of the first lesion to the spreading was more than 2 weeks. In most patients, the primary lesion was plaque, and the secondary lesions (disseminated) were nodules, papules and plaques, with different sizes but smaller than 2.0 cm in diameter. Only 1 patient had frank ulcers (fig. 1, fig. 2, fig. 3, fig. 4). Lesions were present mainly on the face, trunk and upper limbs. Seven patients (25%) had nasal mucosal involvement consisting of ulcers, scabs or septal perforation indicating an important frequency of mucosal involvement.

Bottom Line: Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia) panamensis was identified as the causative agent in 58% of cases.Eighteen patients recovered with pentavalent antimonial.The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis.

View Article: PubMed Central - PubMed

Affiliation: PECET, Medical Research Institute, School of Medicine, University of Antioquia UdeA, Medellín, Colombia.

ABSTRACT
Disseminated leishmaniasis (DL) is a poorly described disease that is frequently misdiagnosed as other clinical manifestations of cutaneous leishmaniasis (CL) such as diffuse CL or post-kala-azar dermal leishmaniasis. Twenty-seven cases of DL diagnosed between 1997 and 2015 are described. A higher prevalence was observed in men (mean age 32 years). The number of lesions per patient ranged from 12 to 294, distributed mainly in the upper extremities, face and trunk. The lesions were mostly plaques or nodules. Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia) panamensis was identified as the causative agent in 58% of cases. Eighteen patients recovered with pentavalent antimonial. The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis.

No MeSH data available.


Related in: MedlinePlus