Academic Journal
Localised cutaneous leishmaniasis in an immunosuppressed host: the role for adjuvant photodynamic therapy after incomplete amphotericin B response.
| Τίτλος: | Localised cutaneous leishmaniasis in an immunosuppressed host: the role for adjuvant photodynamic therapy after incomplete amphotericin B response. |
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| Συγγραφείς: | Caetano DG; Dermatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal caetano97david@gmail.com., Pedroso M; Dermatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal., Teixeira J; Dermatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal., Cardoso JC; Dermatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal., Brites MM; Dermatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal., Oliveira H; Dermatology Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal. |
| Πηγή: | BMJ case reports [BMJ Case Rep] 2026 Sep 28; Vol. 19 (9). Date of Electronic Publication: 2026 Sep 28. |
| Τύπος έκδοσης: | Journal Article; Case Reports |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BMJ Pub. Group |
| Ιατρικοί όροι (MeSH): | Amphotericin B*/therapeutic use , Leishmaniasis, Cutaneous*/drug therapy , Leishmaniasis, Cutaneous*/diagnosis , Leishmaniasis, Cutaneous*/immunology , Antiprotozoal Agents*/therapeutic use , Photochemotherapy*/methods , Aminolevulinic Acid*/analogs & derivatives , Aminolevulinic Acid*/therapeutic use , Immunocompromised Host*, Photosensitizing Agents/therapeutic use ; Leishmania donovani/isolation & purification ; Humans ; Male |
| Περίληψη: | Cutaneous leishmaniasis (CL) caused by the Leishmania donovani complex is uncommon in Europe and can masquerade as malignancy. We describe an immunocompromised man in his 70s with a 15-year verrucous plaque on the right hallux initially suspected as squamous cell carcinoma. Histology revealed macrophages packed with amastigotes; PCR confirmed L. donovani complex infection and serology was strongly positive. Staging excluded mucosal and visceral disease. Systemic liposomal amphotericin B achieved partial regression. Because of persistent hyperkeratosis and the acral site, adjuvant methyl-aminolevulinate photodynamic therapy (MAL-PDT) was added and was well tolerated. One month after the final session, the lesion showed near-complete re-epithelialisation with functional recovery. This case underscores the importance of early biopsy in atypical CL and suggests that MAL-PDT may be a useful adjuvant to amphotericin B in complex CL caused by the L. donovani complex. (© BMJ Publishing Group Limited 2026. No commercial re-use. See rights and permissions. Published by BMJ Group.) |
| Competing Interests: | Competing interests: None declared. |
| Contributed Indexing: | Keywords: Dermatology; Infections; Tropical medicine (infectious disease) |
| Substance Nomenclature: | 7XU7A7DROE (Amphotericin B) 0 (Antiprotozoal Agents) 0 (liposomal amphotericin B) 88755TAZ87 (Aminolevulinic Acid) 585NM85KYM (methyl 5-aminolevulinate) 0 (Photosensitizing Agents) |
| Entry Date(s): | Date Created: 20260928 Date Completed: 20260928 Latest Revision: 20260928 |
| Update Code: | 20260929 |
| DOI: | 10.1136/bcr-2025-270149 |
| PMID: | 42805620 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1757-790X |
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| DOI: | 10.1136/bcr-2025-270149 |