Dermoscopic Changes of a Cutaneous Leishmaniasis Treated with Intralesional Pentavalent Antimonials: A Case Report

Leishmaniasis is a group of parasitic diseases caused by flagellated protozoa of the genus Leishmania with tropism for cells of the reticuloendothelial system, transmitted to many mammals by the bite of the sandfly. They can be visceral, cutaneous or mucocutaneous and represent a public health problem in countries where they are endemic. The diagnosis of cutaneous leishmaniasis is based on epidemiologic, clinical and dermoscopic evidence, with diagnostic certainty established by parasitologic examination, histology or PCR. Dermoscopic findings include erythema, starburst appearance, hyperkeratosis, central ulceration, yellow tears, salmon-colored ovoid structures, glomerular, linear, irregular, hairpin or arborizing vessels, and hypochromic perilesional halo. Pentavalent antimonials are used therapeutically in leishmaniasis, inhibiting ATP synthesis, fatty acids and glycolic oxidation, with immunostimulating and immunoregulatory properties. Our case is a cutaneous leishmaniasis treated with pentavalent antimonials, in which we monitored the dermoscopic appearance of the lesions as the sessions progressed. The salmon-colored ovoid structures were the first to disappear, followed by hyperkeratosis and erosion, then the initially polymorphic vascularization became monomorphic. Yellow tears and erythema were the last structures to disappear. Our article shows that the disappearance of certain structures and the appearance of others can be a good indicator of how close to healing the lesion is.