Cutaneous leishmaniasis in an albino child: a peculiar presentation

Abstract

Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis. It is characterized by nodulo-ulcerative skin lesions and occasionally nodular, papular/plaque, and/or impetiginous lesions on exposed parts of the body. However, other atypical lesions of CL have been reported worldwide such as lupoid, eczematous, erysipeloid, verrucous, dry, zosteriform, paronychial, sporotrichoid, chancriform, annular and erythematous volcanic ulcers. These non-specific lesions often make the diagnosis challenging due to the large number of differential diagnoses and may lead to a delay in the implementation of CL therapy and therefore a higher risk of lifelong scars and major quality of life issues and stigma. We report a case of an 11-year-old immunocompetent albino child boy that presented with 3 years’ history of persistent multiple asymptomatic, small ulcers and cribriform scars of the forehead. Diagnosis of CL was confirmed by detecting Leishmania parasites in tissue specimens, and treatment by antimony drugs resulted in healing of lesion within one month. This is a novel case of a rare, atypical form of CL, which resulted in delayed diagnosis and management. Clinicians, especially those practicing in CL endemic areas like the Americas and the Mediterranean basin, should consider systematically the diagnosis of CL in front of long-lasting and/or non-specific lesions.