孢子丝状皮肤利什曼病:非典型形式

Walter Belda, P. A. Vale, C. H. C. Carvalho
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摘要

利什曼病是由利什曼病属原虫引起的一类种类繁多的传染性和非传染性疾病,被认为是 92 个国家的地方病,每年至少新增 100 万例皮肤利什曼病病例。皮肤利什曼病在热带和新热带地区流行。由于皮肤利什曼病的临床表现多种多样,小到皮肤结节,大到粘膜组织破坏,因此常被称为一组疾病。皮肤利什曼病可由多种利什曼原虫引起,通过沙蝇传播给人类和动物。尽管皮肤利什曼病的发病率在全球范围内不断上升,但由于它很少致命,因此已成为所谓的被忽视疾病之一。在利什曼病流行的国家,通常通过临床诊断,如有可能,还可通过病变活检涂片的显微镜检查来直观地确认利什曼寄生虫是病因。皮肤利什曼病通常表现为溃疡性病变,边缘隆起、浸润,蚊虫叮咬部位通常被描述为框架样边缘。我们报告了一例罕见病例,患者面部和大腿同时出现孢子丝状溃疡,经实验室确诊为皮肤利什曼病临床病变,使用两性霉素 B 脂质体后临床症状好转。
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Sporotrichoid cutaneous leishmaniasis: atypical form
Leishmaniasis comprises a heterogeneous and extensive group of infectious and non-contagious diseases caused by protozoa of the genus Leishmania spp. It is a disease considered endemic in 92 countries, with at least 1 million new cases of integumentary forms annually. Cutaneous leishmaniasis is endemic in the tropics and neotropics. It is often referred to as a group of diseases because of the varied spectrum of clinical manifestations, which range from small cutaneous nodules to gross mucosal tissue destruction. Cutaneous leishmaniasis can be caused by several Leishmania spp. and is transmitted to human beings and animals by sandflies. Despite its increasing worldwide incidence, because it is rarely fatal, cutaneous leishmaniasis has become one of the so-called neglected diseases, In endemic countries, diagnosis is often made clinically and, if possible, by microscopic examination of lesion biopsy smears to visually confirm leishmania parasites as the cause. Cutaneous leishmaniasis often presents as an ulcerated lesion, with raised, infiltrated edges, classically described as frame-like edges at the site of the mosquito bite. We report an uncommon case of a patient who presented with a lesion on the face, sporotrichoid in appearance, and thigh, which appeared simultaneously, of clinical lesions of cutaneous leishmaniasis, laboratory-confirmed and which showed excellent clinical evolution with the use of liposomal amphotericin B.
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