Cutaneous Leishmaniasis as Imitator of Skin Diseases and a Diagnostic Challenge

Abstract

Background: Cutaneous leishmaniasis (CL) usually has a well clinical presentation that rarely confused with other dermatological diseases, but when it presents with atypical picture, it may be a diagnostic challeng e to dermatologist. Objective: To record the cases of CL those have very unusual presentations or sites in the Iraqi patients that might be confused with other dermatoses. Patient and methods: This is a clinical descriptive study that has been performed in the outpatient of Department of Dermatology Baghdad Teaching Hospital, Baghdad , Iraq, during the period from January 2015 - February 2017, where fifty six patients were enrolled in the study. The age of the patients ranged from 1 - 67 years old with median is 30 years, 32 males and 24 females with M:F ratio is 1.3:1, the diagnosis was confirmed by skin smear and/or biopsy. Results: Fifty six cases of CL with atypical presentations and unusual sites that categorized as follow: diffuse nodular 4 cases, paronychia like 1 case, sausage-like CL 4 cases, lupus vulgaris like 2 cases, rosacea like 1case, squamous cell carcinoma-like 3 cases, keratoacanthoma like 1 case, pyoderma gangrenosum-like 2 cases, erysipeloid like 1 case, B-cell lymphoma like 1 case, grouping pattern 1 case, panniculitis-like 2 cases, dermatitis like 2 cases, ecthyma like 1 cases, verruca like 1 case, keloid like 1 case, CL on the scalp 1 case, palmer CL 1 case, CL on the eyelid 1 case, CL on the ear 1 case, CL on the lips 3 cases, one genital CL case and twenty cases of sporotrichosis like spread. Conclusion: Unusual presentations of the CL with atypical lesions should be well recognized and investigated to confirm the diagnosis so that not to be confused with other skin diseases especially in countries where cutaneous leishmaniasis is not endemic disease