10.5826/dpc.1302a87
text/xml
2160-9381
2660
en
 Mouna Rimani
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Erysipeloid Presentation of Cutaneous Leishmaniasis of the Scalp 
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-04-29
2022-06-18
2023-04-29
2023-06-05
e2023087
Dermatol Pract Concept
 Mouna Rimani
2023/04/29
10.5826/dpc.1302a87
e2023087
Department of Pathological Anatomy Hassan, Rabat, Morocco
2160-9381
en
e2023087
Garcias-Ladaria J, López-Brito K, Pascual-López M, Rocamora V. An itching plaque. Dermatol Pract Concept. 31 janv 2015;5(1):51‑3. Doi: 10.5826/dpc.0501a09
Erysipeloid Presentation of Cutaneous Leishmaniasis of the Scalp 
https://dpcj.org/index.php/dpc/article/download/2660/2096
                  Erysip­eloid Presentation of Cutaneous
                        Leishmaniasis of the Scalp
                                              Awatef Kelati1, Mouna Rimani2


1 Dermatology department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS),
  Casablanca, Morocco
2 Department of Pathological Anatomy Hassan, Rabat, Morocco



Citation: Kelati A, Rimani M. Erysipeloid Presentation of Cutaneous Leishmaniasis of The Scalp.
Dermatol Pract Concept. 2023;13(2):e2023087. DOI: https://doi.org/10.5826/dpc.1302a87
Accepted: September 14, 2022; Published: April 2023
Copyright: ©2023 Kelati et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Kelati Awatef, Dermatology Department, Cheikh Khalifa International University Hospital,
Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco. E-mail: akelati@um6ss.ma




Case Presentation                                                        The identification of parasite species by PCR was not per-
                                                                         formed. Meglumine antimoniate was out of stock at that
A 39-year-old man from the area of Tinghir in Morocco, was               period, so, we prescribed doxycycline and aureomycine oint-
referred to the Dermatology consultation with a 6-month his-             ment for 12 weeks, with a significant amelioration, then the
tory of mild itchy skin lesions of the forehead. The physical            patient received intramuscular injection of glucantime for
examination showed an extensive erythematous infiltrated                 20 days because of the persistence of a slight erythema, a
plaque of the forehead and the fronto-temporal area. Der-                complete remission was then achieved.
moscopy revealed perifollicular scales, yellow dots, follicular
keratotic plugs, and branching vessels on an erythematous
                                                                         Teaching Points
orange background (Figure 1). After a negative slit-skin
smear, which was performed because of the high frequency                 Cutaneous leishmaniasis (CL) can have atypical clinical pre-
of leishmaniasis in that endemic area of Morocco, and be-                sentations with sometimes a negative slit-skin smear, espe-
cause of the suggestive dermoscopic appearance especially                cially in chronic granulomatous presentations, however, CL
the yellow dots and plugs on an orange-erythematous back-                could be highly suspected on dermoscopy. Follicular kera-
ground. Skin biopsy showed diffuse tuberculoid granuloma-                totic plugs, generalized erythema with vascular structures
tous infiltrate without caseous or fibrinoid necrosis, with the          are the most common dermoscopic features [1]. The diagno-
presence of Leishman bodies (Figure 1), which confirmed                  sis confirmation relies on the skin smear or histopathology
the diagnosis of granulomatous cutaneous leishmaniasis.                  findings [2].




Image Letter | Dermatol Pract Concept. 2023;13(2):e2023087                                                                         1
        Figure 1. (A) Cutaneous leishmaniasis. Extensive erythematous infiltrated plaque of the forehead and the fronto-­
        temporal area. (B) Dermoscopy revealed perifollicular witish scales and erythema (green arrow), yellow dots (­yellow ar-
        rows), follicular keratotic plugs (gray circle), and branching vessels (red arrow) on an erythematous orange ­background.
        Histopathology (C, H&E) and Giemsa Stain (D): diffuse tuberculoid granulomatous infiltrate without caseous or
        ­fibrinoid necrosis, with the presence of Leishman bodies. Magnification x 400.




References                                                             2. Garcias-Ladaria J, López-Brito K, Pascual-López M, Rocamora
                                                                          V. An itching plaque. Dermatol Pract Concept. 2015;5(1):51‑53.
1. Serarslan G, Ekiz Ö, Özer C, Sarıkaya G. Dermoscopy in the             DOI: 10.5826/dpc.0501a09. PMID: 25692083. PMCID:
   Diagnosis of Cutaneous Leishmaniasis. Dermatol Pract Con-              PMC4325692.
   cept. 2019;9(2):111‑118. DOI: 10.5826/dpc.0902a06. PMID:
   31106013. PMCID: PMC6502294.




2                                                                            Image Letter | Dermatol Pract Concept. 2023;13(2):e2023087
