Unexpected diagnosis of basal cell carcinoma in a patient presenting with a secondary location of Leishmania parasites in the skin

• Published in: The Pan African medical journal Vol. 34; no. 8; p. 8
• Main Authors: Ben Abda, Imène, Ben-Abdallah, Rym, Hammami, Houda, Ben Abid, Meriem, Mdimagh-Kchir, Hela, Bahri, Karim, Siala, Emna, Aoun, Karim, Bouratbine, Aida
• Format: Journal Article
• Language: English
• Published: Uganda African Field Epidemiology Network 2019; The African Field Epidemiology Network; The Pan African Medical Journal
• Subjects: Aged; Amphotericin B - administration & dosage; Antifungal agents; Antiprotozoal Agents - administration & dosage; basal cell carcinoma; Biopsy; Blood tests; Carcinoma, Basal Cell - diagnosis; Carcinoma, Basal Cell - pathology; Case Report; Deoxyribonucleic acid; DNA; Family medical history; Female; Fever; HIV; Human immunodeficiency virus; Humans; Infections; Laboratories; leishmania infantum; Leishmania infantum - isolation & purification; leishmaniasis; Leishmaniasis, Cutaneous - diagnosis; Leishmaniasis, Cutaneous - drug therapy; Leishmaniasis, Visceral - diagnosis; Leishmaniasis, Visceral - drug therapy; Medical diagnosis; Parasites; Parasitic diseases; Parasitology; Patients; Polymerase Chain Reaction; real time pcr; Skin cancer; skin leishmaniasis; Skin Neoplasms - diagnosis; Skin Neoplasms - pathology; Tropical diseases; Tunisia; Tunisia; real time PCR; Leishmania infantum; Basal cell carcinoma; skin leishmaniasis; leishmaniasis
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2019.34.8.18946

We report here a case of simultaneous cutaneous and visceral manifestations due to diagnosed in an immunocompetent adult. We describe a 74-year-old woman from Tunis, Tunisia, who presented a biologically confirmed visceral leishmaniasis infection concomitant with arm ulceration which appeared 2 years before. DNA was detected by ITS PCR in both buffy coat and dermal scrapping of the arm lesion. Sequencing revealed that the 2 isolated strains corresponded to and were 100% identical. The symptoms of visceral leishmaniasis responded to amphotericin B with rapid healing. However, the skin lesion did not improve although PCR on dermal sample became negative. This location is probably secondarily to lymphatic or blood dissemination during the systemic visceral leishmaniasis infection. It would be favored by the inflammatory environment induced by the basal cell carcinoma subsequently diagnosed.