RESUMEN
The authors present a clinical report of deforming mucocutaneous leishmaniasis of the nose in a native American woman, left untreated for 25 years. The nose was reconstructed using the local tissue displaced as flaps, and using cartilage grafts taken from the nasal septum and the ear shell. To the best of the authors' knowledge, the literature offers just 1 report on a similar patient.
Asunto(s)
Leishmaniasis Mucocutánea/complicaciones , Leishmaniasis Mucocutánea/patología , Deformidades Adquiridas Nasales/parasitología , Deformidades Adquiridas Nasales/cirugía , Rinoplastia/métodos , Anciano de 80 o más Años , Femenino , Humanos , Deformidades Adquiridas Nasales/patologíaAsunto(s)
Gluconato de Sodio Antimonio/uso terapéutico , Antiprotozoarios/uso terapéutico , Ataxia Telangiectasia/complicaciones , Leishmaniasis Mucocutánea/inmunología , Deformidades Adquiridas Nasales/inmunología , Ataxia Telangiectasia/inmunología , Niño , Diagnóstico Tardío , Progresión de la Enfermedad , Femenino , Humanos , Huésped Inmunocomprometido , Leishmaniasis Mucocutánea/complicaciones , Leishmaniasis Mucocutánea/patología , Deformidades Adquiridas Nasales/parasitología , Deformidades Adquiridas Nasales/patología , Pronóstico , Insuficiencia del TratamientoRESUMEN
BACKGROUND: Mucocutaneous leishmaniasis is a granulomatous disease clinically characterized by ulcerated skin and mucosal lesions. Mucocutaneous leishmaniasis is very rare in India and to our knowledge, only two cases have been reported, and this is the first case of mucocutaneous leishmaniasis presenting with mutilating rhinopathy reported from the Indian subcontinent. CASE REPORT: A 64-year-old man presented with a destructive ulceration of the central face of 23 years' duration, who was diagnosed to have mucocutaneous leishmaniasis, and showed dramatic response to intramuscular injections of sodium stibogluconate. RESULTS: Histopathologic examination of skin biopsy revealed a granulomatous infiltrate with the presence of leishmania donovani (LD) bodies. The clinical picture, plus the pathologic findings, and the response to sodium stibogluconate confirmed mucocutaneous leishmaniasis. CONCLUSION: Mucocutaneous leishmaniasis is a rare disease in the Indian subcontinent, and clinicians from this region should have a high index of suspicion on encountering mucocutaneous ulcerative lesions.