Cutaneous leishmaniasis: 20 years' experience in a Spanish tertiary care hospital

Actas Dermosifiliogr. 2015 May;106(4):310-6. doi: 10.1016/j.ad.2014.12.003. Epub 2015 Feb 10.
[Article in English, Spanish]

Abstract

Introduction and objectives: Cutaneous leishmaniasis is the most common form of leishmaniasis, which is endemic in Spain. The aim of this study was to evaluate the epidemiological and clinical characteristics of cutaneous leishmaniasis seen in our hospital over a period of 20 years, with a particular focus on clinical differences according to immune status and origin of infection

Materials and methods: We performed a chart review of 67 cases of cutaneous leishmaniasis diagnosed between 1992 and 2012. Follow-up data were available for 54 patients.

Results: Fifty-four patients with cutaneous leishmaniasis were included in the study. Of these, 26 had been diagnosed between 1992 and 2002 and 28 between 2003 and 2012. The mean age at diagnosis was 49 years, there was a predominance of male patients, and the mean time from onset of symptoms to consultation was 3 months. The most common clinical manifestations were plaques and ulcers. Most of the immunodepressed patients and patients with imported leishmaniasis had skin ulcers and/or multiple lesions. During the first decade of the study, diagnosis was based on clinical and histologic findings. These were supported by molecular techniques in the second decade. Pentavalent antimonials were the treatment of choice, producing good results and very few adverse effects

Conclusion: The number of patients with cutaneous leishmaniasis and with compromised immune status was similar in the periods 1992-2002 and 2003-2013, but more cases of imported leishmaniasis were diagnosed in the second period. Patients with ulcers and/or multiple lesions should be evaluated to rule out immunosuppression or infection by Leishmania species from other parts of the world. Both systemic and intralesional meglumine antimonate was effective and safe.

Keywords: Antimoniato de meglumina; Cutaneous; Cutánea; Immunodepressed; Inmunodeprimido; Leishmaniasis; Meglumine antimonate.

MeSH terms

  • Adolescent
  • Adult
  • Africa, Northern / ethnology
  • Aged
  • Antiprotozoal Agents / therapeutic use
  • Comorbidity
  • Emigrants and Immigrants
  • Endemic Diseases
  • Female
  • HIV Infections / epidemiology
  • Humans
  • Immunocompromised Host
  • Latin America / ethnology
  • Leishmaniasis, Cutaneous / drug therapy
  • Leishmaniasis, Cutaneous / epidemiology*
  • Male
  • Meglumine / therapeutic use
  • Meglumine Antimoniate
  • Middle Aged
  • Organometallic Compounds / therapeutic use
  • Retrospective Studies
  • Spain / epidemiology
  • Tertiary Care Centers
  • Young Adult

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Meglumine
  • Meglumine Antimoniate