Atypical Manifestations of Old World Cutaneous Leishmaniasis: A Systematic Review and Clinical Atlas of Unusual Clinical and Specific Anatomical Presentations

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-09-18 DOI:10.1002/hsr2.71273

Bahareh Abtahi-Naeini, Seyed Naser Emadi, Zabihollah Shahmoradi, Mahsa Pourmahdi-Boroujeni, Ali Saffaei, Fereshte Rastegarnasab

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Abstract

Background and Aims

Cutaneous leishmaniasis (CL) represents the most common form of leishmaniasis. It imposes a significant medical burden due to long-lasting ulcers and disfiguring scars, underscoring the need for comprehensive CL control strategies, particularly in endemic regions. This study aims to classify atypical CL presentations for clinical practitioners. Additionally, we compiled and categorized original images from our clinical encounters with CL to create a clinical atlas enhancing the existing literature.

Methods

A systematic search for atypical manifestations of Old World CL was conducted in June 2023 via the PubMed database, utilizing MeSH-based keywords including leishmaniasis, atypical, manifestation, and characteristics. All of the records were included. Exclusion criteria included records published before the 20th century, non-English articles, review articles, nonclinical studies (experimental and epidemiological), studies focusing on New World CL (based on the study geographical location), or focusing on Post-Kala-Azar leishmaniasis. Relevant articles were selected and assessed.

Results

Based on the clinical manifestations described in the selected studies, articles were classified into the following categories: (a) subacute CL, (b) chronic CL, (c) CL associated with lymphatic involvement, (d) CL associated with an immunocompromised state, and (e) cutaneous leishmaniasis on special anatomical sites. Clinical, diagnostic, and therapeutic facets were subsequently explored.

Conclusion

The diagnosis of leishmaniasis can be challenging. Given the broadening spectrum of differential diagnoses for CL in clinical settings, dermatologists, pediatric dermatologists, internists, infectious disease specialists, and pediatricians must be aware of this classification of atypical CL.

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旧大陆皮肤利什曼病的非典型表现：不寻常的临床和特殊解剖表现的系统回顾和临床图谱

背景和目的皮肤利什曼病（CL）是利什曼病最常见的形式。由于长期溃疡和毁容疤痕，它造成了重大的医疗负担，强调需要制定全面的CL控制战略，特别是在流行地区。本研究旨在为临床医师分类非典型CL表现。此外，我们从临床遇到的CL中编译和分类原始图像，以创建临床地图集，增强现有文献。方法利用基于mesh的关键词：利什曼病、非典型、表现、特征，于2023年6月通过PubMed数据库系统检索旧大陆CL的非典型表现。所有的记录都包括在内。排除标准包括20世纪以前发表的记录、非英文文章、综述文章、非临床研究（实验和流行病学）、以新世界CL（基于研究地理位置）为重点的研究或以黑热病后利什曼病为重点的研究。选择并评估相关文章。根据所选研究中描述的临床表现，文章被分为以下几类：(a)亚急性CL， (b)慢性CL， (c)伴有淋巴受累的CL， (d)伴有免疫功能低下状态的CL，以及(e)特殊解剖部位的皮肤利什曼病。随后探讨了临床、诊断和治疗方面的问题。结论利什曼病的诊断具有挑战性。鉴于临床环境中CL的鉴别诊断范围越来越广，皮肤科医生、儿科皮肤科医生、内科医生、传染病专家和儿科医生必须意识到这种非典型CL的分类。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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