Carcinoma basocelular de piel y diagnóstico diferencial de leishmaniosis mucocutánea

Abstract

Context: Leishmaniasis is a parasitic disease caused by twenty different species of the Leishmania protozoan and transmitted to man by the bite of the female mosquito of the genus Phlebotomine. The clinical manifestations are variable and are related to the infestant species, its relationship with the environment and the host’s immune response. Cutaneous and mucocutaneous (LMC) leishmaniasis affects the skin and mucous membranes of the upper respiratory tract; It is present in Latin America where it is mainly produced by the species Leishmania (Viannia) braziliensis. The initial signs are erythema and ulcerations at the level of nostrils followed by destructive inflammation that can extend to affect the nasal septum and in some cases pharynx or larynx, seriously disfiguring the face and compromising the patient’s life. Case presentation: The case of a 90-year-old man from the northwest of the Pichincha Province is presented; It presents several ulcerative lesions located at the level of the right nasal bridge, internal angle of the right eye and homolateral cheek, covering an area approximately 4 cm in diameter. Initially, CML was suspected and several doses of pentavalent antimony (Glucantime©) were applied. Diagnostic tests were performed for leishmaniasis (smear, culture and skin test of Montenegro) which were negative. The histopathological study determined that it was a basal cell carcinoma of the skin (CBC). Conclusions: In endemic areas of LC and CML, it is necessary to make an adequate differential diagnosis with other pathologies that cause ulcerative lesions, including basal cell carcinoma of the skin, avoiding administering pentavalent antimony indiscriminately.