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American leishmaniasis may cause serious deformities which need to be remedied by plastic surgery. My case is a striking example of extensive mutilation caused by the long-continued disease, due to the patient's carelessness with regard to treatment and possibly also to the development of resistance to treatment. The negative results of microscopic search for leishmanias do not nullify the diagnosis, as the duration of the eruption was extremely long and as the patient was treated again and again. When the disease is of long duration, it is much more difficult to find the parasite than when the onset is recent. In inveterate cases, the specificity of the process diminishes according to the law of Levandowsky and Jadassohn. In diagnosis, the disease must be differentiated from syphilis (fig. 1), leprosy and lupus.
REPORT OF A CASE
J. A., a white Brazilian farmer, lived at Uberlandia. The family history showed
Costa OG. MUTILATING FORM OF AMERICAN LEISHMANIASIS. Arch Derm Syphilol. 1944;50(5):328. doi:10.1001/archderm.1944.01510170042012
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