Dermatofibroma parasitized by Leishmania in HIV infection: a new morphologic expression of dermal Kala Azar in an immunodepressed patient

Castellano, Victor Manuel; Rodríguez-Peralto, José L.; Alonso, Sergio; Fuente, E. Gómez-de la; Ibarrola, Carolina

doi:10.1111/j.1600-0560.1999.tb01799.x

Cited by 26 publications

(14 citation statements)

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“…Cutaneous manifestation of leishmaniasis in patients co‐infected with HIV is associated with clinical polymorphism and a challenging differential diagnosis, especially in nonendemic areas. Various manifestations have been reported, including papulonodular, ulcerative, infiltrative, lepromatous and diffuse, psoriasis‐like, keloid, histoid, Kaposi sarcoma‐like or dermatofibroma‐like lesions . Such lesions were mostly observed on the face, extremities and acral area .…”

Section: Discussionmentioning

confidence: 99%

Chronic generalized fibrotic skin lesions from disseminated leishmaniasis caused by Leishmania martiniquensis in two patients from northern Thailand infected with HIV

et al. 2015

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SummaryBackground Leishmaniasis is a newly emerging infection in Thailand. Most of the previous human cases have presented with the clinical features of visceral leishmaniasis and were mainly found in southern Thailand. Here we report the first two patients from northern Thailand presenting with disseminated cutaneous leishmaniasis. Objectives To determine the nature of the infection of leishmaniasis and to identify the species of parasite responsible. Methods Clinical investigations included the taking of biopsy samples and histology. Parasitological diagnosis was performed by establishment of Leishmania promastigote cultures, and identification was performed by DNA sequencing of four independent gene loci (ribosomal RNA internal transcribed spacer 1; large subunit of RNA polymerase II; heat shock protein 70; RPL23a intergenic sequence). Results Both patients were infected with HIV, and had multiple cutaneous lesions and accompanying visceral leishmaniasis. They had similar cutaneous manifestations characterized by chronic generalized fibrotic lesions, which were more prominent on traumatic areas. In both patients the parasite was identified as Leishmania martiniquensis. This is a recently described species that is distinct and only distantly related to the classical agents of cutaneous leishmaniasis in Asia (Leishmania major and Leishmania tropica) or of visceral leishmaniasis (Leishmania donovani and Leishmania infantum). Each patient responded well to therapy with intravenous amphotericin B followed by oral itraconazole. Conclusions Leishmania martiniquensis is a cause of cutaneous leishmaniasis in Thailand.

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Section: Discussionmentioning

confidence: 99%

Chronic generalized fibrotic skin lesions from disseminated leishmaniasis caused by Leishmania martiniquensis in two patients from northern Thailand infected with HIV

et al. 2015

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“…20,21 There is only 1 report in the literature that describes the coexistence of a dermatofibroma with Leishmania parasitic colonization in human immunodeficiency virus-coinfected and visceral leishmaniasis coinfected patient. 28 Like macrophages, DDs express on their surface immunoglobulin Fc fraction and complement receptors that are also critical for Leishmania phagocytosis and internalization. 29 We can speculate if FXIIIa+ DDs are able to destroy the parasites such as macrophages, 30 or these cells may inhibit Leishmania multiplication as LCs are supposed to do.…”

Section: Discussionmentioning

confidence: 99%

Factor XIIIa+ Dermal Dendrocyte Parasitism in American Tegumentary Leishmaniasis Skin Lesions

Sotto¹,

Halpern²,

Kauffman³

et al. 2010

The American Journal of Dermatopathology

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Dendritic cells belong to a family of antigen-presenting cells that are localized at the entry sites, such as skin and mucosa. Dendritic cells are related to immune surveillance function. The role of Langerhans cells in the pathogenesis of skin infectious diseases is well studied; however, there are few articles addressing involvement of factor XIIIa-positive dermal dendrocytes (FXIIIa+ DD) in such processes. FXIIIa+ DDs are bone marrow-monocytic lineage-derived cells and members of the skin immune system. Due to their immune phenotype and functional characteristics, they are considered complementary cells to Langerhans cells in the process of antigen presentation and inducing immune response. To verify the interaction between FXIIIa+ DD and Leishmania amastigotes, 22 biopsies of American tegumentary leishmaniasis (ATL) skin lesions were subjected to double staining technique with anti-factor XIIIa and anti-Leishmania antibodies. FXIIIa+ DDs were hypertrophic and abundant in the cutaneous reaction of ATL. FXIIIa+ DDs harboring parasites were observed in 11 of 22 skin biopsies. The data obtained suggest that FXIIIa+ DD plays a role in the pathogenesis of ATL skin lesion as host cell, immune effector, and/or antigen-presenting cell.

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“…6 The latter includes the presence of Leishmania in herpes zoster virus and herpes simplex virus (HSV) infections, bacillary angiomatosis and dermatofibroma. 6,7 Cutaneous leishmaniasis may also resemble dermatofibroma clinically and histologically, as the latter may encompass a spindle cell pseudotumoral reaction with parasitized protozoa. 8…”

Section: Infective Diagnostic Pitfallsmentioning

confidence: 99%

Dermatopathological challenges in the human immunodeficiency virus and acquired immunodeficiency syndrome era

Ramdial

2009

Histopathology

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Ramdial P K (2010) Histopathology56, 39–56 Dermatopathological challenges in the human immunodeficiency virus and acquired immunodeficiency syndrome era The histopathological assessment of cutaneous lesions is critical to the definitive diagnosis of many human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome‐associated dermatoses, infections and tumours. Dermatopathological challenges stem mainly from the altered histopathological profile of established cutaneous entities compared with that in the HIV‐unaffected population, the emergence of new diseases and the impact of therapeutic modalities on cutaneous lesions. This review focuses on some of these diagnostic dilemmas, with emphasis on the following challenges: (i) infective diagnostic pitfalls; (ii) itchy papular skin lesions; (iii) co‐lesional comorbid diseases; (iv) drug‐induced disease alterations; and (v) neoplastic and pseudoneoplastic proliferations. The drug‐induced alterations include highly active antiretroviral therapy‐associated disease modifications.

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Dermatofibroma parasitized by Leishmania in HIV infection: a new morphologic expression of dermal Kala Azar in an immunodepressed patient

Cited by 26 publications

References 14 publications

Chronic generalized fibrotic skin lesions from disseminated leishmaniasis caused by Leishmania martiniquensis in two patients from northern Thailand infected with HIV

Chronic generalized fibrotic skin lesions from disseminated leishmaniasis caused by Leishmania martiniquensis in two patients from northern Thailand infected with HIV

Factor XIIIa+ Dermal Dendrocyte Parasitism in American Tegumentary Leishmaniasis Skin Lesions

Dermatopathological challenges in the human immunodeficiency virus and acquired immunodeficiency syndrome era

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