Case Report: Lupoid cutaneous leishmaniasis mimicking verruca plana

Abstract

Cutaneous leishmaniasis (CL) is an infectious disease caused by various species of leishmania protozoan parasites. Lupoid CL is a rare form of CL that has a stunning similarity to other granulomatous cutaneous conditions of infectious or inflammatory origin. Verruca plana, also known as a “flat wart”, is a benign proliferation of the skin resulting from infection with human papilloma virus (HPV). Herein, we presented a case of lupoid CL mimicking verruca plana on the face.

Localization of Lupoid Leishmaniasis on the face: A case control study

“…8 Despite this, the patient cannot completely eliminate the parasite. 4,12 The pathogenetic mechanism is possibly related to changes in the cellular immune response, which can lead to relapsing lesions. The altered balance between T Helper (Th1) and Th2 cells, 13 with consequent production of interleukin-4 (IL-4), can lead to high susceptibility to parasitic infections and to the unusual clinical manifestation.…”

“…The altered balance between T Helper (Th1) and Th2 cells, 13 with consequent production of interleukin-4 (IL-4), can lead to high susceptibility to parasitic infections and to the unusual clinical manifestation. 4,14 CD4 + Th1 cells' interaction with antigen-presenting cells through the release of interferon (IFN)-gamma plays a critical role in controlling Leishmania infection. IFN-gamma stimulates activated macrophages to produce nitric oxide, which results in the intracellular killing of the Leishmania amastigotes.…”

“…The pathogenetic mechanism is possibly related to changes in the cellular immune response, which can lead to relapsing lesions. The altered balance between T Helper (Th1) and Th2 cells, 13 with consequent production of interleukin‐4 (IL‐4), can lead to high susceptibility to parasitic infections and to the unusual clinical manifestation 4,14 . CD4 + Th1 cells' interaction with antigen‐presenting cells through the release of interferon (IFN)‐gamma plays a critical role in controlling Leishmania infection.…”

“…[1][2][3] Clinical manifestations can range from localized cutaneous involvement to systemic multiorgan disease, depending on the interaction between the host's immune response and parasite virulence. 4 While some species only result in cutaneous or visceral disease, others can result in both. 5 Cutaneous disease typically presents as painless solitary lesions or multiple lesions on exposed areas of the body, especially the face and extremities, 1 due to the inability of sand fly mouthparts to penetrate through clothing.…”

“…Clinical manifestations can range from localized cutaneous involvement to systemic multiorgan disease, depending on the interaction between the host's immune response and parasite virulence 4 . While some species only result in cutaneous or visceral disease, others can result in both 5 …”