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June 1992

Cutaneous Leishmaniasis Treated With Controlled Localized Heating

Author Affiliations

University of Arizona Health Sciences Center, Tucson

Arch Dermatol. 1992;128(6):759-761. doi:10.1001/archderm.1992.01680160041003

REPORT OF A CASE  A 37-year-old man of Sudanese origin visited his homeland for 2 weeks. Shortly after his return, he noted numerous nonhealing "sores" on his extremities and neck that enlarged over the succeeding 4 weeks. A 2-week course of systemic antibiotics administered by his physician failed to improve the condition.The patient was seen in consultation and was noted to have 10 exudative red nodules and plaques. Unroofed, shaggy ulcerations were noted (Fig 1).Findings from the skin biopsy specimen showed a granulomatous infiltrate with epithelioid cells and multinucleated giant cells. No organisms were detected.A portion of the biopsy specimen was cultured on NNN (Novy, MacNeal, and Nicole) medium at 25°C.1 After 5 days, promastigotes with the morphologic appearance of Leishmania tropica were noted.

THERAPEUTIC CHALLENGE  Although the individual lesions were substantive and had the potential for chronic manifestations and postinflammatory scarring,