amphotericin-b and Leishmaniasis--Diffuse-Cutaneous

Topics: Adult; Amphotericin B; Antiprotozoal Agents; Coinfection; Darier Disease; Drug Therapy, Combination; HIV Infections; Humans; Infusions, Intravenous; Leishmaniasis, Diffuse Cutaneous; Male; Phosphorylcholine; Skin Diseases, Parasitic; Treatment Outcome; Trypanosoma cruzi

Leishmaniasis is a parasitic infection endemic to more than 90 countries worldwide. As travel to endemic areas increases, dermatologists need to keep this entity in the differential for any chronic skin lesion in persons who may have had a possible exposure for any duration. It can be difficult to diagnose because manifestations are varied and sometimes subclinical. This article discusses the current state of epidemiology, pathogenesis, clinical presentation, diagnosis, and treatment options. A special focus is placed on cutaneous manifestations and their treatment.

Topics: Amphotericin B; Antimony Sodium Gluconate; Antiprotozoal Agents; Deoxycholic Acid; Drug Combinations; Humans; Incidence; Leishmania braziliensis; Leishmania donovani; Leishmania mexicana; Leishmania tropica; Leishmaniasis, Diffuse Cutaneous; Leishmaniasis, Mucocutaneous; Leishmaniasis, Visceral; Phosphorylcholine; Polymerase Chain Reaction; Travel

Topics: Adult; Amphotericin B; Antifungal Agents; Deoxycholic Acid; Drug Combinations; HIV Infections; Humans; Leishmaniasis, Diffuse Cutaneous; Male

This case report highlights the risk of severe cutaneous leishmaniasis (CL) by

Topics: Adrenal Cortex Hormones; Amphotericin B; Antiprotozoal Agents; Humans; Immunocompromised Host; Immunosuppressive Agents; Leishmania infantum; Leishmaniasis, Diffuse Cutaneous; Male; Middle Aged; Psoriasis; Rheumatic Fever; Risk Factors; Spain; Tumor Necrosis Factor-alpha

AbstractSeveral case reports of autochthonous leishmaniasis in Thailand have been published since 1996. Most of the previous cases presented with visceral leishmaniasis (VL) and were mostly reported in southern part of Thailand. Recently, it has been evident that

Topics: Adult; Amphotericin B; Antiprotozoal Agents; Antiviral Agents; Coinfection; Dermis; DNA, Ribosomal Spacer; Female; HIV; HIV Infections; Humans; Itraconazole; Leishmania; Leishmaniasis, Diffuse Cutaneous; Protozoan Proteins; RNA Polymerase II; Sequence Analysis, DNA; Thailand

AbstractReported herein is the first case of

Topics: Adult; Amphotericin B; Antiprotozoal Agents; Coinfection; Cytochromes b; Fatal Outcome; HIV; HIV Infections; Humans; Leishmania guyanensis; Leishmaniasis, Diffuse Cutaneous; Male; Meglumine; Meglumine Antimoniate; Organometallic Compounds; Protozoan Proteins; Sequence Analysis, DNA; Shock, Septic; Skin; Treatment Failure

Topics: Adult; Amphotericin B; Antiprotozoal Agents; Female; Humans; Leishmaniasis, Diffuse Cutaneous; Male; Treatment Outcome

Topics: Administration, Oral; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Anti-Infective Agents; Biopsy; Fluconazole; Humans; Leishmania tropica; Leishmaniasis, Diffuse Cutaneous; Male; Skin; Treatment Outcome

American cutaneous leishmaniasis is an important endemic zoonotic disease in the New World that comprises a spectrum of clinical manifestations. Diffuse cutaneous leishmaniasis (DCL) is a rare form of the disease characterized by antigen-specific immunodeficiency that often presents with multiple disfiguring non-ulcerated confluent nodules or plaques that involve large areas of the skin, resembling lepromatous leprosy. Relapse is invariable in advanced stages, despite aggressive chemotherapy, and a plethora of drugs has been tested with unchanging results. We report on a severe an exceptional case that resolved after treatment with amphotericin B, a drug considered only mildly effective, and discuss the therapeutic approach to this disease.

Topics: Adolescent; Amphotericin B; Antiprotozoal Agents; Facial Dermatoses; Humans; Leishmaniasis, Diffuse Cutaneous; Male

Leishmaniasis is emerging as a common and serious opportunistic disease for patients with HIV infection. Almost all cases of HIV-Leishmania coinfection have been described in Mediterranean countries and they occur with various clinical presentations, ranging from typical visceral forms to asymptomatic or atypical cases, including cutaneous and mucocutaneous leishmaniasis. Pentavalent antimony compounds have been the mainstays of antileishmanial therapy for half a century and new lipid formulations of amphotericin B seem reliable, but the most effective treatment remains unknown. We describe a patient who was HIV infected and an intravenous drug user, with an unusual disseminated cutaneous leishmaniasis, after an initial visceral disease and after a 13-month maintenance treatment with liposomal amphotericin. The severe concurrent immunosuppression probably played an essential role in leading to this atypical cutaneous form, characterized by diffuse, nonulcerated, nonscabby maculopapular lesions.

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Humans; Leishmaniasis, Diffuse Cutaneous; Leishmaniasis, Visceral; Male