Dermatology: Practical and Conceptual


Image Letter  |  Dermatol Pract Concept 2020;10(3):e2020062 1

Dermatology Practical & Conceptual

Clinical Presentation

A 66-year-old man presented with 2 asymptomatic ulcer-

ations on the right cheek (Figure 1). These began as enlarging 

papules that ulcerated 2 weeks later. He had been treated for 

leishmaniasis a year previously, with an ulcer in the same loca-

tion. Diagnosis had been made by skin biopsy and polymerase 

chain reaction, identifying Leishmania braziliensis. At that 

time, he was given intramuscular meglumine antimoniate; his 

lesions had healed completely within 1 month.

Teaching Point

Leishmaniasis recidivans (LR) is a rare presentation of local-

ized cutaneous leishmaniasis, recurring at the site of a previ-

ously healed ulcer [1], as in this case. It typically affects the 

face, often the cheek. Leishmania braziliensis is one of the 

species linked to New World LR. While the pathogenesis of 

LR is not known, risk factors include parasite resistance and 

incomplete treatment. Resistance to antimonials is increas-

ingly a concern in some regions [2].

References

1.  Masood S, Naveed S, Alvi RU. Infiltrated leishmaniasis recidi-

vans cutis on the face: a rare clinical presentation. Trop Doct. 

2012;42(2):120-121. https://doi.org/10.1258/td.2011.110396

2.  Ponte-Sucre A, Gamarro F, Dujardin JC, et al. Drug resistance and 

treatment failure in leishmaniasis: a 21st century challenge. PLoS 

Negl Trop Dis. 2017;11(12):e0006052. https://doi.org/10.1371/

journal.pntd.0006052

Leishmaniasis Recidivans in Rural Venezuela
Ariadna Perez Sanchez1, Rajani Katta2

1 Department of Internal Medicine, The University of Texas Health Science Center, San Antonio, TX, USA

2 Department of Dermatology, McGovern Medical School, Houston, TX, USA

Key words: leishmaniasis recidivans, Leishmania braziliensis, localized cutaneous leishmaniasis, ulceration, antimonials

Citation: Perez Sanchez A, Katta R. Leishmaniasis recidivans in rural Venezuela. Dermatol Pract Concept. 2020;10(3):e2020062. DOI: 
https://doi.org/10.5826/dpc.1003a62

Accepted: April 16, 2020; Published: June 29, 2020

Copyright: ©2020 Perez Sanchez and Katta. This is an open-access article distributed under the terms of the Creative Commons 
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source 
are credited.

Funding: None.

Competing interests: The authors have no conflicts of interest to disclose.

Authorship: Both authors have contributed significantly to this publication.

Corresponding author: Rajani Katta, MD, McGovern Medical School at UT Health Houston, 6800 West Loop South, Ste. #180, Bellaire, 
TX 77401, USA. Email: info@kattamd.com

Figure 1. Two ulcer-

ations on the right 

cheek, overlying scar 

from previous infec-

tion.

https://doi.org/10.1258/td.2011.110396
https://doi.org/10.1371/journal.pntd.0006052
https://doi.org/10.1371/journal.pntd.0006052
https://doi.org/10.5826/dpc.1003a62