Cheng-Huang Chang, Kan-Tang Fang, Chung-Hsing Chang
Department of Dermatology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
Infection with protozoan parasites of the genus Leishmania causes a variety of clinical diseases called leishmaniasis, which is transmitted to human host by the bite of a sandfly. Here, we present a Taiwanese man with cutaneous leishmaniasis after he had traveled to Sri Lanka. A 35-year-old man had a painless erythematous nodule with central ulceration on the ventral side of the right wrist. The skin lesion developed 3 weeks after he returned to Taiwan from Sri Lanka to rescue tsunami sufferers. Excisional biopsy revealed dense and diffuse infiltration of histiocytes and lymphocytes throughout the dermis, and numerous amastigotes were identified in the cytoplasm of the histiocytes. Nine months after he was first treated, his skin lesion recurred at the same location. Under the diagnosis of cutaneous leishmaniasis, he underwent a second excision and took 400 mg itraconazole per day for 4 months. No further recurrence or internal organ involvement was noted.
Cutaneous leishmaniasis; Sri Lanka; Traveler