Cutaneous Leishmaniasis – Dermoscopic Findings And Cryotherapy

• Main Authors: Dobrev Hristo P., Nocheva Desislava G., Vuchev Dimitar Iv., Grancharova Rumyana D.
• Format: Article
• Language: English
• Published: Pensoft Publishers 2015-03-01
• Series: Folia Medica
• Subjects: Leishmaniasis cutanea; dermoscopy; cryotherapy; кожный лейшманиоз; дерматоскопия; криотерапия
• Online Access: http://www.degruyter.com/view/j/folmed.2015.57.issue-1/folmed-2015-0021/folmed-2015-0021.xml?format=INT

We present a 60-year-old male patient who, three months after a holiday in Southern Greece, found a small ‘pimple’ on his back, which gradually got as big as a small walnut, the central part becoming ulcerated and scabby. Dermatological examination found an erythematous-to-livid nodular lesion on the right shoulder; it was 16 mm in diameter with central ulceration, covered with brownish crust which discharged pus-like secretion upon pressure. Microscope examination of Romanowsky-Giemsa stained lesion material detected amastigote forms of Leishmania tropica. The culture investigation and serological tests for leishmaniasis were negative. Dermoscopy of the lesion found the following features: erythema, hyperkeratosis, central ulceration covered with brownish crust, “yellow tears-like” structures and “white starburst-like” patterns, and various vascular structures (including dotted vessels, comma-shaped vessels, hairpin- and glomerular-like vessels). The patient was diagnosed with cutaneous leishmaniasis and underwent four cryotherapy sessions every other week with excellent therapeutic results - complete resolution of infiltrate with subsequent gentle hypopigmented scarring. In conclusion, dermoscopy is an easily accessible non-invasive method which can be useful for the diagnosis of cutaneous leishmaniasis. Cryotherapy is the treatment of choice for single skin lesions.