Cases reported "Skin Ulcer"

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1/12. Extensive cutaneous leishmaniasis of the upper limb in a patient with leukemia.

    An unusual case of extensive cutaneous leishmaniasis of the upper limb in a patient with leukemia is presented. A trial of medical therapy (sodium stibogluconate) resulted in rapid healing of the large ulcers. The incidence of leishmaniasis is increasing globally as a result of the ease of travel and migrating populations. hand surgeons worldwide should have a high index of suspicion of this parasitic infection of the upper limb and should be aware of its unusual presentation in immunocompromised patients.
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keywords = leishmaniasis
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2/12. A patient with intestinal amoebiasis and cutaneous amoebic ulcer.

    This paper reports a patient with intestinal amoebiasis in concomitant with amoebic ulcer in the thigh. The ulcer was suspected to be carcinoma, complicated cutaneous leishmaniasis or due to free-living amoebae. The diagnosis was confirmed by the pathological and parasitological demonstration of haematophagous trophozoites of E. histolytica. The patient was successfully treated with metronidazole.
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keywords = leishmaniasis
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3/12. Diffuse cutaneous leishmaniasis with atypical aspects.

    A 16-year-old man had long-standing diffuse cutaneous leishmaniasis with the following characteristics: diffuse infiltrated lesions rich in amastigotes, absence of mucosal involvement, and lack of parasite-specific cell-mediated immune response. In situ identification of leishmania mexicana amazonensis was achieved by the use of monoclonal antibodies. Clinically, as an atypical finding there was deep and extensive ulceration in the lower limbs. Histologically, an atypical characteristic was the presence of a high number of eosinophils in the infiltrate predominantly in the ulcerated lesion. Ultrastructurally, parasitized and lysed eosinophils with dispersion of their granules were seen in the vicinity of parasitized or lysed macrophages.
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keywords = leishmaniasis
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4/12. Ulcerated disseminated cutaneous leishmaniasis associated with vitiligo, hypothyroidism, and diabetes mellitus in a patient with down syndrome.

    We report a 35-year-old man who was referred to our dermatology department with multiple, nodular, ulcerated, and crusted lesions disseminated on the face, trunk, and extremities. He has a known diagnosis of down syndrome. The past medical history also included vitiligo (for 20 years), hypothyroidism (for 2 years), and type-II diabetes mellitus (for 3 months). Direct smear of an ulcer was positive for leishmania. skin biopsy confirmed the diagnosis. A leishmanin skin test was negative. polymerase chain reaction (PCR) from two separate skin biopsies demonstrated the presence of leishmania major. To our knowledge, this is the first report of disseminated cutaneous leishmaniasis (DCL) caused by L. major in iran, and also the first report of association between DCL with down syndrome, vitiligo, hypothyroidism, and diabetes mellitus.
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ranking = 0.83333333333333
keywords = leishmaniasis
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5/12. Atypical clinical variants in New World cutaneous leishmaniasis: disseminated, erysipeloid, and recidiva cutis due to Leishmania (V.) panamensis.

    In recent times, there has been an increase in the number of reports for new and rare variants of cutaneous leishmaniasis (CL). Here, we describe three unusual clinical forms of CL identified in Ecuadorian children. A total of 131 patients with CL were diagnosed over a 2-year period of active search. In 3 (2.29%), the lesions were very unusual; these included erysipeloid, recidiva cutis (LRC), and disseminated leishmaniasis (DL). The erysipeloid case is characterized by erythematous and indurated plaque seen on the face of a 5-year-old boy; the LRC one is differentiated by slowly progressing red-brown papules around large scars of healed sores in a 6-year-old girl, and the DL case is characterized by dozens of cutaneous ulcers distributed in the whole body of a 1-year-old girl. Leishmania parasites were isolated by lesion aspirate and analyzed by the technique multilocus enzyme electrophoresis (MLEE). All three isolates were identified as Leishmania (Viannia) panamensis. These distinct clinical variants rarely have been reported previously in the American cutaneous leishmaniasis, and for the first time L. (V.) panamensis was identified as the etiologic agent. Our cases extend the spectrum of clinical presentations in New World leishmaniasis.
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ranking = 1.3333333333333
keywords = leishmaniasis
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6/12. Trigeminal trophic syndrome.

    Trigeminal trophic syndrome is an unusual condition also known as trigeminal neurotrophic ulceration or trigeminal neuropathy with nasal ulceration. The diagnosis is suggested when ulceration of the face, especially of the ala nasi, occurs in a dermatome of the trigeminal nerve that has been rendered anesthetic by a surgical or other process involving the trigeminal nerve or its central sensory connections. A history of paresthesias and self-induced trauma to the area further support the diagnosis. Neurological deficits causing trigeminal trophic syndrome may result from surgical trigeminal ablation, vascular disorders and infarction of the brainstem, acoustic neuroma, postencephalitic parkinsonism, and syringobulbia. The following etiologies of nasal ulceration should be excluded: postsurgical herpetic reactivation and ulceration, syphilis, leishmaniasis, leprous trigeminal neuritis, yaws, blastomycosis, paracoccidioidomycosis, lethal midline granuloma, pyoderma gangrenosum, Wegener's granulomatosis, and basal cell carcinoma. In the case reported here, the diagnosis of TTS was made primarily as a result of previous experience with the syndrome, underscoring the importance of physician recognition of this unusual disorder.
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ranking = 0.16666666666667
keywords = leishmaniasis
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7/12. Active cutaneous leishmaniasis in Brazil, induced by leishmania donovani chagasi.

    L.d. chagasi was isolated from active cutaneous leishmaniasis in both human and canine infections in an endemic area in Rio de Janeiro, Brazil. Both isolates were identified by molecular and immunological characterization of the parasite using three different methods: electrophoretic mobility of isoenzymes; restriction endonuclease fragment analysis of kDNA and serodeme analysis using monoclonal antibodies. This seems to be the first well documented case in the New World of a "viscerotropic" Leishmania inducing a case of cutaneous leishmaniasis. This observation emphasizes that the diagnosis of the etiologic agent of human or canine visceral leishmaniasis based solely upon clinical and epidemiological criteria may lead to erroneous conclusions.
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ranking = 1.1666666666667
keywords = leishmaniasis
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8/12. Failure of oral ketoconazole to cure cutaneous ulcers caused by leishmania braziliensis.

    ketoconazole failed to cure cutaneous lesions caused by leishmania braziliensis in two patients. A prior study had suggested that ketoconazole was efficacious against this form of leishmaniasis.
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keywords = leishmaniasis
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9/12. sporothrix schenckii inoculation on the abdomen.

    sporotrichosis is usually transmitted by cutaneous inoculation and is, therefore, most often seen on the face, extremities, and other exposed areas. We have described the case of a pilot who contracted sporotrichosis overseas and in whom the initial lesion was on the abdomen. Since the patient reported that he had been bitten by an insect at that site, the diagnosis of leishmaniasis had been strongly considered.
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ranking = 0.16666666666667
keywords = leishmaniasis
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10/12. Fatal fungaemia due to sporothrix schenckii.

    A clinical case is reported of a 78-year-old male with antecedents of diabetes and alcoholism who was hospitalized because he showed cutaneous lesions on the face and extremities suggesting cutaneous tuberculosis, but after a first histological study cutaneous leishmaniasis was erroneously diagnosed. Because of some unusual characteristics of the patient, the skin biopsies were carefully re-examined, as well as blood smears, which revealed elongated yeast form-like cells suggestive of sporothrix schenckii. The diagnosis was confirmed when the fungus grew in mice and in Sabouraud cultures inoculated with blood samples from the patient. It is recommended that Sp. schenckii is included in the differential diagnosis of ulcerative cutaneous lesions in patients from Mexican humid areas.
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ranking = 0.16666666666667
keywords = leishmaniasis
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