A pyoderma gangrenous-like cutaneous leishmaniasis in a Libyan woman with rheumatoid arthritis: a case report

BMC Research Notes
Hamida Al-DwibeMokhtar Maree

Abstract

Several case reports describe diseases presenting with skin ulcerations, which resemble pyoderma gangrenosum especially in immune-compromised patients, often proven on further workup, to have an infective or malignant etiology. However, treatment of pyoderma gangrenosum by systemic steroids or other immunosuppressive agents may worsen the condition. We report here, a 45 year-old Libyan woman with rheumatoid arthritis on low dose steroids with pyoderma gangrenosum-like skin lesions and positive pathergy. Slit-smear was positive for Leishmania amastigotes and histopathological examination confirmed the diagnosis of cutaneous leishmaniasis. The lesions healed completely by parenteral sodium stibogluconate (Pentostam) 600 mg daily. We report for the first time, a rare and unusual presentation of pyoderma gangrenosum like-cutaneous leishmaniasis in a patient with rheumatoid arthritis. Atypical cutaneous leishmaniasis should not be ruled out in the differential diagnosis of unresponsive skin diseases, with slit/smear and a skin biopsy is required.

References

Jan 1, 1996·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R D Pearson, A Q Sousa
Aug 26, 1999·Journal of the European Academy of Dermatology and Venereology : JEADV·S UzunH R Memişoğlu
Mar 15, 2002·American Journal of Clinical Dermatology·Christine M Choi, Ethan A Lerner
Dec 21, 2006·BMC Infectious Diseases·Silvia PittalisPasquale Narciso
Mar 21, 2007·Parasite Immunology·M P QuinonesS S Ahuja
Nov 22, 2008·Transactions of the Royal Society of Tropical Medicine and Hygiene·Ahmad AmroZiad Abdeen
Jun 23, 2012·PLoS Neglected Tropical Diseases·Ahmad AmroGabriele Schönian
Sep 2, 2014·Parasites & Vectors·Hamida Al-DwibeAhmad Amro
Sep 8, 2017·PLoS Neglected Tropical Diseases·Ahmad AmroKatrin Kuhls

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Methods Mentioned

BETA
ESR
biopsy
biopsies

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