A pyoderma gangrenous‑like cutaneous leishmaniasis in a Libyan woman with rheumatoid arthritis: a case report
Date
2018-03-01
Authors
Al‑Dwibe, Hamida
Amro, Ahmad
Gashout, Aisha
El‑Zurghany, Ali
El‑zubi, Said
El‑Hashme, Mohamed
Hamarsheh, Omar
Maree, Mokhtar
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
Background: Several case reports describe diseases presenting with skin ulcerations, which resemble pyoderma
gangrenosum especially in immune-compromised patients, often proven on further workup, to have an infective or
malignant etiology. However, treatment of pyoderma gangrenosum by systemic steroids or other immunosuppressive
agents may worsen the condition.
Case presentation: We report here, a 45 year-old Libyan woman with rheumatoid arthritis on low dose steroids with
pyoderma gangrenosum-like skin lesions and positive pathergy. Slit–smear was positive for Leishmania amastigotes
and histopathological examination confirmed the diagnosis of cutaneous leishmaniasis. The lesions healed completely
by parenteral sodium stibogluconate (Pentostam) 600 mg daily.
Conclusion: We report for the first time, a rare and unusual presentation of pyoderma gangrenosum like-cutaneous
leishmaniasis in a patient with rheumatoid arthritis. Atypical cutaneous leishmaniasis should not be ruled out in the
differential diagnosis of unresponsive skin diseases, with slit/smear and a skin biopsy is required.
Description
Keywords
Leishmania , Pyoderma gangrenous , Cutaneous leishmaniasis , Rheumatoid arthritis