Carcinoma basocelular de piel y diagnóstico diferencial de leishmaniosis mucocutánea

Authors

  • William Cevallos

DOI:

https://doi.org/10.29166/rfcmq.v43i2.2834

Keywords:

Ecuador, Mucocutaneous leishmaniasis, basal cell carcinoma, differential diagnosis

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.

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References

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González VM, Gramajo MJ, Escobar CM, Costas LR, Ruzzi IM, Picardi NL, et al. Dermatoscopía del

carcinoma basocelular: criterios clásicos y actuales. Arch Argent Dermatol 2012; 62:87–91.

Calvopiña M, Armijos RX, Marco JD, Uezato H, Kato H, Gomez EA, et al. Leishmania isoenzyme

polymorphisms in Ecuador: relationships with geographic distribution and clinical presentation.

BMC Infect Dis 2006; 6:139.

Zegarra del Carpio R, Sanchez Saldaña L. Leishmaniasis cutanea: presentación en placa verrucosa.

Dermatología Peru 2005; 15:62–5.

Organización Mundial de la Salud. Control de la leishmaniasis. Ser Inf Técnicos [Internet]. 2010; 949.

Available from: http://apps.who.int/gb/ebwha/pdf_files/EB126/B126_16-sp.pdf

Hashiguchi Y, Hosokawa A, Maruno M, Takamiyagi A, Nonaka S, Gomez E, et al. Differential diagnosis of cutaneous leishmaniasis in endemic areas of Ecuador. In: Studies on New World leishmaniasis and its transmission with particular reference to Ecuador. Kochi, Japan: reserch report series;

pp 58–68.

McGwire BS, Satoskar a. R. Leishmaniasis: clinical syndromes and treatment. QJM [Internet]. 2014;

(1):7–14. Available from: http://www.qjmed.oxfordjournals.org/cgi/doi/10.1093/qjmed/hct116

Vazquez- Cajina A. Dermaología. 2012; 69(603):325–9.

Rueda X, Hart AA De, Aristizabal L. Guías de práctica clínica para el tratamiento del carcinoma basocelular. 2008; 16(2):102–17.

TenSeldam R, Helwig E. Histological typing of kidney tumours. International classification of tumours. In: International Histological Classification of Tumours. World Health Organization; 1974.

pp 78–9.

Miranda E, Quintana S, Piña V, Sergio López RM. Carcinoma basocelular: presentación de un caso

clínico. ADM 2014; 71(5):231–6.

Briceño RW, Pérez H. Caso columella nasal. Serv Cirugía Oncológica. Clínica Nuestra Señora del

Pilar 2007; 45(4):33–6.

Carucci J, Leffell D. Basal cell carcinoma. IGARSS 2014. 2009. pp 1036–48.

González VM, Gramajo MJ, Escobar CM, Costas LR, Ruzzi IM, Picardi NL, et al. Dermatoscopía del

carcinoma basocelular: criterios clásicos y actuales. Arch Argent Dermatol 2012; 62:87–91.

Published

2018-12-01

How to Cite

1.
Cevallos W. Carcinoma basocelular de piel y diagnóstico diferencial de leishmaniosis mucocutánea. Rev Fac Cien Med (Quito) [Internet]. 2018 Dec. 1 [cited 2025 Mar. 11];43(2):161-6. Available from: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/2834