Work

Cutaneous leishmaniasis due to Leishmania (L.) mexicana: first imported case reported in Portugal

Year: 2025

Type: article

Abstract: Cutaneous leishmaniasis due to Leishmania (L.) mexicana: first imported case reported in Portugal ଝ Dear Editor,Leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania, transmitted through the bite of infected phlebotomine sandflies.1---3 Leishmaniasis is endemic in tropical, subtropical, and Mediterranean regions, with its distribution spanning the Old World (Africa, Asia, the Middle East, the Mediterranean Basin) and the New World (Central and South America).3 Leishmaniasis has different clinical presentations, including visceral leishmaniasis (VL), cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (ML).1,3,4 In Portugal, VL is endemic, with dogs serving as the primary reservoir and CL is considered a rare disease.5,6 CL typically presents in exposed areas (e.g.face, neck, extremities) as painless solitary or multiple papulonodules that may progress to necrosis, ulceration, and scarring.1,4 Leishmania (L.) mexicana is primarily found in Central America, Mexico, and Texas.4 This species is associated with small, chronic cutaneous ulcers, with a spontaneous healing rate exceeding 75% within three months.1,4 We report the case of a 32-year-old man with an erythematous nodule on the chin, showing central ulceration covered by yellowish exudate and crusts, with a documented progression over three months (Fig. 1).Six months prior, he had travelled to Mexico (Bacalar jungle) and had been previously treated with antibiotics, without improvement.Initial wound cultures isolated Klebsiella aerogenes, prompting treatment with targeted ciprofloxacin for three weeks, with partial improvement.Histopathological examination revealed dermal macrophages containing numerous intracellular Leishmania amastigotes (Figs. 2 and 3), further corroborated by a positive skin culture.L. mexicana was identified by molecular techniques using Internal Transcribed Spacer 1 -Polymerase Chain Reaction -Restriction

Source: Anais Brasileiros de Dermatologia

DOI: 10.1016/j.abd.2025.501223

Authors: Mélissa M. de Carvalho, Sofia Cortes, José Manuel Cristóvão, José Carlos Cardoso, Maria Goreti Catorze, Alexandre Miroux-Catarino

Institutions: Hospital de Egas Moniz, University of Lisbon, Universidade Nova de Lisboa, Unidade Local de Saúde de Coimbra

Language: English

Topic: Research on Leishmaniasis Studies

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,700