Chronic Cutaneous Lesions of Unknown Origin

Abstract

Leishmaniasis is a notable health problem in many countries around the world as well as in Turkey. The disease is vectorborne and carried by female sandflies and seen mostly in childhood but it may affect individuals in every age group. Typical lesion formation begins with the occurrence of erythema and papule following the bite of the causative sandfly. Afterward, ulceration may occur following the nodule formation. Regional lymphadenomegaly may accompany. A 5-year-old Syrian girl who was admitted to our outpatient clinic with a non-healing wound on her right eyebrow and eye contour will be discussed in this part. In her dermatologic examination, an erythematous infiltrated lesion with a yellow crust on the right eyebrow area and orbita was observed. Besides, nail-like protrusions were detected on the lower surface of the removed crust. The patient did not remember being stung or bitten by an insect. In the dermoscopic examination, generalized erythema and hyperkeratosis with yellow tears were present. The patient had no symptoms such as pain or itching. May-Grünwald Giemsa smear from the wound, histopathology, and polymerase chain reaction (PCR) assay were utilized on clinical suspicion. The patient was diagnosed with cutaneous Leishmaniasis. No regression was present after intramuscular meglumine antimoniate and fluconazole treatments. Intravenous liposomal amphotericin B was applied for 7 days with a dose of 5 mg/kg/day. The existing lesion was completely regressed except erythema during follow up.