Cutaneous leishmaniasis treatment by metronidazole: study of 30 cases

Service de dermatologie, CHU Monastir, Tunisie.
La Presse Médicale (Impact Factor: 1.08). 11/2008; 38(2):325-6. DOI: 10.1016/j.lpm.2008.09.008
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    • "In Tunisia, CL diagnosis is based on direct parasitology tests to detect leishmania parasites, DNA research of leihmaniases via PCR (a new technique recently used in Tunisia) and on the histopathological examination of skin biopsy [7]. There are several therapeutic options such as cryotherapy , heat therapy with radiofrequency, topical treatment, oral treatments such as fluconazole, metronidazole [8]. "
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    ABSTRACT: We report the epidemiological and clinical characteristics of the erysipeloid form of cutaneous leishmaniasis as well as its diagnostic and therapeutic challenges. CASE REPORT: A 63-year-old woman, with no medical history, presented with a one-month history of erythematous nasal swelling. The lesion appeared after an accidental trauma. Erythematous infiltrative plaque was noted on the center of the face. There were also crust formations on the traumatic region. Despite local treatment and oral antibiotherapy, there was no improvement. The diagnosis of cutaneous leishmaniasis was confirmed by positive skin smears. Histopathological examinations of a skin biopsy showed no malignancy. The patient was treated intramuscularly with 10mg/kg per day systemic meglumine antimoniate with partial regression of symptoms. CONCLUSION: The erysipeloid type is a rare and unusual presentation of cutaneous leishmaniasis that often causes late diagnosis. Diagnosis is confirmed by the demonstration of the parasite by skin smear, histopathological examination and polymerase chain reaction. There are various therapeutic options. The evolution is generally favourable.
    European Annals of Otorhinolaryngology, Head and Neck Diseases 04/2011; 128(2):95-7. DOI:10.1016/j.anorl.2010.09.008 · 0.82 Impact Factor
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    ABSTRACT: Objectif Rapporter les caractéristiques épidémiologiques et cliniques de la forme érysipéloïde de leishmaniose cutanée ainsi que ses difficultés diagnostiques et thérapeutiques. Présentation du cas Une patiente de 63 ans, sans antécédents, a consulté pour une tuméfaction nasale inflammatoire évoluant depuis un mois apparue suite à un traumatisme nasal. L’examen clinique a révélé un placard érythémateux, infiltré centrofacial recouvert par endroits de croûtes. Une antibiothérapie avec des soins locaux quotidiens n’ont pas entraîné une amélioration. La biopsie cutanée n’a pas montré de signes de malignité et le frottis cutané a confirmé le diagnostic. Un traitement par méglumine antimoniale par voie intramusculaire a été instauré à la dose de 10 mg/kg par jour avec une régression partielle. Conclusion La forme érysipéloïde de leishmaniose cutanée constitue une entité rare et inhabituelle entraînant souvent un retard diagnostique. Le diagnostic repose sur l’examen parasitologique direct, la recherche de l’ADN des leishmanies par PCR et sur l’examen histologique. Il existe plusieurs options thérapeutiques. L’évolution est généralement favorable.
    Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale 04/2011; 128(2):107-109. DOI:10.1016/j.aforl.2010.12.006
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    ABSTRACT: Cutaneous leishmaniasis is a major world health problem. Diagnosis is suspected on evocative clinical presentation in patients living in or coming from endemic areas. Several methods have been used. The smear is a simple investigation used in endemic regions. The culture enables to identify the specimen. PCR has a high sensitivity. Montenegro's reaction is used in the epidemiological study. Pentavalent antimony derivatives remain the mainstay of systemic treatment. Their efficiency is well established. Their toxicity should be researched. Other treatments can be utilized, such as miltefosine. Local therapy is used in uncomplicated lesions. Injections of the pentavalent antimony derivate, cryotherapy and paromomycin ointmentsis are important options and should be used more frequently in Old World leishmaniasis.
    Journal of Dermatological Case Reports 06/2013; 7(2):31-41. DOI:10.3315/jdcr.2013.1135
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