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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">American tegumentary leishmaniasis &#40;ATL&#41; is an infectious disease caused by protozoa of the genus <span class="elsevierStyleItalic">Leishmania</span> transmitted by the bite of a female sandfly of the genus <span class="elsevierStyleItalic">Lutzomyia</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In Brazil&#44; it is found in all states&#44; with Amazonas and Par&#225; accounting for 58&#37; of reported cases between 2007 and 2017&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The three main species responsible for ATL in Brazil are <span class="elsevierStyleItalic">L&#46;&#40;V&#46;&#41; braziliensis</span>&#44; <span class="elsevierStyleItalic">L&#46;&#40;V&#46;&#41; guyanensis</span>&#44; and <span class="elsevierStyleItalic">L&#46;&#40;L&#46;&#41; amazonensis</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Epidemiological data and polymerase chain reaction &#40;PCR&#41; analysis may be essential for the diagnosis of unusual clinical forms&#44; and&#47;or in the absence of amastigotes in smears and histological sections&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">This case report describes a 49-year-old male patient&#44; a farmer&#44; without comorbidities&#44; from Mau&#233;s&#44; state of Amazonas&#44; Brazil&#46; He sought medical care at a Dermatology service complaining of a condition which had started three years before&#44; with a papule on the proximal phalanx of the third finger&#44; progressing to an ulcer that extended to the dorsum of the right hand&#46; Considering the clinical picture&#44; nine direct tests were performed to search for amastigotes&#44; all with negative results&#46; Different types of treatments with antibiotics and corticoids were prescribed without improvement&#44; and with worsening and progression of the lesions for the last six months&#46; On examination&#44; an ulcer was observed on the dorsum of the right hand&#44; covered by yellowish crusts&#44; with clear and erythematous borders&#44; which extended to the phalanges&#44; resulting in anatomical deformity of the third finger&#46; There were also nodules following an ascending lymphatic path&#44; in the right forearm&#44; some of which showed painless ulceration&#44; with raised erythematous borders&#44; measuring approximately 2<span class="elsevierStyleHsp" style=""></span>cm &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figs&#46; 1</a>A and <a class="elsevierStyleCrossRef" href="#fig0005">1</a> B&#41;&#46; Histopathological examination of biopsies from the lesion located on the dorsum of the hand and from a nodule on the forearm revealed the presence of granulomatous inflammatory infiltrate consisting of histiocytes&#44; epithelioid cells&#44; giant cells&#44; several plasmocytes&#44; lymphocytes&#44; and the presence of rare amastigotes &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The PCR sequencing&#44; carried out with the aid of primers described by Gra&#231;a et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> on the biopsy fragment identified the species <span class="elsevierStyleItalic">Leishmania guyanensis</span>&#46; The bacteriological culture of the fragment from the dorsum of the hand was positive for the Gram-negative bacillus <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#46; The radiological examination showed bone sequestration and destruction of the cortex of the distal and middle phalanges of the third finger&#44; suggestive of chronic osteomyelitis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The combined treatment consisting of meglumine antimoniate 1200<span class="elsevierStyleHsp" style=""></span>mg of Sb<span class="elsevierStyleSup">&#43;5</span>&#47;day intravenously for 30 days and cefepime&#44; according to the sensitivity identified in the antibiogram&#44; at a dose of 1<span class="elsevierStyleHsp" style=""></span>g 2&#215;&#47;day for 10 days&#44; resulted in significant improvement in the skin lesions &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; The patient is currently undergoing multidisciplinary follow-up with the orthopedics service for surgical treatment of the osteomyelitis after regression of the skin ulcer&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">ATL can be classified into localized cutaneous&#44; disseminated&#44; diffuse&#44; and mucocutaneous leishmaniasis&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The typical lesion of localized cutaneous leishmaniasis is initially a papule that progresses to an ulcer with a raised&#44; infiltrated border and a granular background&#44; which may be accompanied by regional lymphadenopathy and&#47;or nodular lymphangitis&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; the clinical forms of pleomorphic and atypical aspects can hinder and delay the diagnosis and&#44; consequently&#44; adequate treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Among the atypical forms of ATL&#44; the verrucous&#44; lupoid&#44; eczematous&#44; zosteriform&#44; tumor&#44; acneiform&#44; and sporotrichoid forms have been reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> Pazok Hossein et al&#46; described cases similar to the one described in the present case report as lupoid variants of ATL in patients from Afghanistan and Turkey&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The diagnosis should be based on epidemiology&#44; lesion characteristics&#44; direct examination&#44; and culture&#46; In atypical cases&#44; histopathological examination and PCR are fundamental tools&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Direct examination is the most frequently used method for diagnosis because it is simple&#44; inexpensive and easy to perform&#46; However&#44; the probability of finding the parasite is inversely proportional to the time of evolution of the skin lesions&#44; being rare after one year&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">On histopathology&#44; intense granulomatous inflammatory infiltrate is observed&#44; and histiocytes&#44; epithelioid and giant cells&#44; lymphocytes&#44; plasma cells&#44; some eosinophils&#44; and depending on the time of evolution&#44; macrophages containing amastigotes can be seen&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">PCR&#44; a method based on parasite DNA amplification&#44; has a sensitivity and specificity of 100&#37; in the typical forms and a sensitivity of 94&#37; in atypical presentations&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a> In this case&#44; PCR compatible with <span class="elsevierStyleItalic">Leishmania guyanensis</span> was crucial for the correct diagnosis and starting treatment&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The rare bone involvement reported in cases of ATL and proven infection by <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#44; as well as the radiological alterations suggestive of persistent chronic osteomyelitis in the radiological control&#44; suggest that the bone lesions observed in the present case were caused by contiguity from the secondary infection&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> However&#44; histopathological examination and culture of the bone lesion are necessary&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Despite its wide distribution in Brazil&#44; atypical presentations of ATL can make the diagnosis difficult&#46; Therefore&#44; the relevance of epidemiology and PCR in atypical lesions is highlighted&#44; as well as the importance of an early diagnosis&#44; so that sequelae or mutilations can be prevented&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financial support</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Authors&#39; contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Dina Fabr&#237;cio da Silva&#58; Approval of the final version of the manuscript&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sidharta Quercia Gadelha&#58; Approval of the final version of the manuscript&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Andr&#233;a de Souza Cavalcante&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Rosilene Viana de Andrade&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; participation in the writing of the histopathological report&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Jorge Augusto de Oliveira Guerra&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Alcidarta dos Reis Gadelha&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and epidemiological profiles of patients with American cutaneous leishmaniasis from the states of Pernambuco and Amazonas&#44; Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Melo"
                            1 => "R&#46; Morais"
                            2 => "T&#46;C&#46; Goes"
                            3 => "R&#46; Silva"
                            4 => "R&#46;F&#46; Morais"
                            5 => "J&#46; Guerra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Soc Bras Med Trop&#46;"
                        "fecha" => "2020"
                        "volumen" => "53"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and validation of PCR-based assays for diagnosis of American cutaneous leishmaniasis and identification of the parasite species"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;C&#46; Gra&#231;a"
                            1 => "A&#46;C&#46; Volpini"
                            2 => "G&#46;A&#46;S&#46; Romero"
                            3 => "M&#46;P&#46; de O&#46; Neto"
                            4 => "M&#46; Hueb"
                            5 => "R&#46; Porrozzi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0074-02762012000500014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mem Inst Oswaldo Cruz&#46;"
                        "fecha" => "2012"
                        "volumen" => "107"
                        "paginaInicial" => "664"
                        "paginaFinal" => "674"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22850958"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atypical presentations of cutaneous leishmaniasis&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;B&#46; Meireles"
                            1 => "L&#46;C&#46; Maia"
                            2 => "G&#46;C&#46; Soares"
                            3 => "I&#46;P&#46;P&#46; Teodoro"
                            4 => "M&#46; do S&#46;V&#46; Gadelha"
                            5 => "C&#46;G&#46;L&#46; da Silva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.actatropica.2017.05.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Trop&#46;"
                        "fecha" => "2017"
                        "volumen" => "172"
                        "paginaInicial" => "240"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28526427"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous leishmaniasis&#58; a great imitator"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Gurel"
                            1 => "B&#46; Tekin"
                            2 => "S&#46; Uzun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2019.10.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2020"
                        "volumen" => "38"
                        "paginaInicial" => "140"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32513395"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sporotrichoid cutaneous leishmaniasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Er-Rami"
                            1 => "H&#46; Lahlou"
                            2 => "S&#46; Benjelloun"
                            3 => "A&#46; Jakar"
                            4 => "A&#46; Khalloufi"
                            5 => "M&#46; El Haouri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.annder.2011.10.406"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol&#46;"
                        "fecha" => "2012"
                        "volumen" => "139"
                        "paginaInicial" => "171"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22325764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupoid leishmaniasis among the known cases of cutaneous leishmaniasis in Herat Province&#44; western Afghanistan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Pazoki"
                            1 => "M&#46; Fakhar"
                            2 => "A&#46; Rasooli"
                            3 => "M&#46; Karamian"
                            4 => "E&#46; Nazar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jiph.2015.12.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Public Health&#46;"
                        "fecha" => "2016"
                        "volumen" => "9"
                        "paginaInicial" => "557"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26796767"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Observa&#231;&#245;es &#243;sseas na leishmaniose cut&#226;neo difusa &#40;LCD&#41; no Estado do Maranh&#227;o"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;C&#46;R&#46; Saldanha"
                            1 => "T&#46;S&#46; Malheiros"
                            2 => "C&#46;C&#46;R&#46; Rodrigues"
                            3 => "I&#46;T&#46;A&#46; Balby"
                            4 => "J&#46;M&#46;L&#46; Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0037-86821995000100011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Soc Bras Med Trop&#46;"
                        "fecha" => "1995"
                        "volumen" => "28"
                        "paginaInicial" => "55"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7724870"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
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Letter - Tropical/Infectious and parasitic dermatology
Mutilating localized cutaneous leishmaniasis caused by Leishmania guyanensis
Dina Fabrício da Silvaa,
Corresponding author
dina.fabricio@hotmail.com

Corresponding author.
, Sidharta Quercia Gadelhaa, Andréa de Souza Cavalcantea, Rosilene Viana de Andradea, Jorge Augusto de Oliveira Guerrab, Alcidarta dos Reis Gadelhac
a Department of Dermatology, Fundação de Dermatologia Tropical Heitor Vieira Dourado, Manaus, AM, Brazil
b Department of Leishmaniasis, Fundação de Dermatologia Tropical Heitor Vieira Dourado, Manaus, AM, Brazil
c Department of Dermatopathology, Fundação de Dermatologia Tropical Heitor Vieira Dourado, Manaus, AM, Brazil
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analysis may be essential for the diagnosis of unusual clinical forms&#44; and&#47;or in the absence of amastigotes in smears and histological sections&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">This case report describes a 49-year-old male patient&#44; a farmer&#44; without comorbidities&#44; from Mau&#233;s&#44; state of Amazonas&#44; Brazil&#46; He sought medical care at a Dermatology service complaining of a condition which had started three years before&#44; with a papule on the proximal phalanx of the third finger&#44; progressing to an ulcer that extended to the dorsum of the right hand&#46; Considering the clinical picture&#44; nine direct tests were performed to search for amastigotes&#44; all with negative results&#46; Different types of treatments with antibiotics and corticoids were prescribed without improvement&#44; and with worsening and progression of the lesions for the last six months&#46; On examination&#44; an ulcer was observed on the dorsum of the right hand&#44; covered by yellowish crusts&#44; with clear and erythematous borders&#44; which extended to the phalanges&#44; resulting in anatomical deformity of the third finger&#46; There were also nodules following an ascending lymphatic path&#44; in the right forearm&#44; some of which showed painless ulceration&#44; with raised erythematous borders&#44; measuring approximately 2<span class="elsevierStyleHsp" style=""></span>cm &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figs&#46; 1</a>A and <a class="elsevierStyleCrossRef" href="#fig0005">1</a> B&#41;&#46; Histopathological examination of biopsies from the lesion located on the dorsum of the hand and from a nodule on the forearm revealed the presence of granulomatous inflammatory infiltrate consisting of histiocytes&#44; epithelioid cells&#44; giant cells&#44; several plasmocytes&#44; lymphocytes&#44; and the presence of rare amastigotes &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The PCR sequencing&#44; carried out with the aid of primers described by Gra&#231;a et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> on the biopsy fragment identified the species <span class="elsevierStyleItalic">Leishmania guyanensis</span>&#46; The bacteriological culture of the fragment from the dorsum of the hand was positive for the Gram-negative bacillus <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#46; The radiological examination showed bone sequestration and destruction of the cortex of the distal and middle phalanges of the third finger&#44; suggestive of chronic osteomyelitis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The combined treatment consisting of meglumine antimoniate 1200<span class="elsevierStyleHsp" style=""></span>mg of Sb<span class="elsevierStyleSup">&#43;5</span>&#47;day intravenously for 30 days and cefepime&#44; according to the sensitivity identified in the antibiogram&#44; at a dose of 1<span class="elsevierStyleHsp" style=""></span>g 2&#215;&#47;day for 10 days&#44; resulted in significant improvement in the skin lesions &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; The patient is currently undergoing multidisciplinary follow-up with the orthopedics service for surgical treatment of the osteomyelitis after regression of the skin ulcer&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">ATL can be classified into localized cutaneous&#44; disseminated&#44; diffuse&#44; and mucocutaneous leishmaniasis&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The typical lesion of localized cutaneous leishmaniasis is initially a papule that progresses to an ulcer with a raised&#44; infiltrated border and a granular background&#44; which may be accompanied by regional lymphadenopathy and&#47;or nodular lymphangitis&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; the clinical forms of pleomorphic and atypical aspects can hinder and delay the diagnosis and&#44; consequently&#44; adequate treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Among the atypical forms of ATL&#44; the verrucous&#44; lupoid&#44; eczematous&#44; zosteriform&#44; tumor&#44; acneiform&#44; and sporotrichoid forms have been reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> Pazok Hossein et al&#46; described cases similar to the one described in the present case report as lupoid variants of ATL in patients from Afghanistan and Turkey&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The diagnosis should be based on epidemiology&#44; lesion characteristics&#44; direct examination&#44; and culture&#46; In atypical cases&#44; histopathological examination and PCR are fundamental tools&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Direct examination is the most frequently used method for diagnosis because it is simple&#44; inexpensive and easy to perform&#46; However&#44; the probability of finding the parasite is inversely proportional to the time of evolution of the skin lesions&#44; being rare after one year&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">On histopathology&#44; intense granulomatous inflammatory infiltrate is observed&#44; and histiocytes&#44; epithelioid and giant cells&#44; lymphocytes&#44; plasma cells&#44; some eosinophils&#44; and depending on the time of evolution&#44; macrophages containing amastigotes can be seen&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">PCR&#44; a method based on parasite DNA amplification&#44; has a sensitivity and specificity of 100&#37; in the typical forms and a sensitivity of 94&#37; in atypical presentations&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5</span></a> In this case&#44; PCR compatible with <span class="elsevierStyleItalic">Leishmania guyanensis</span> was crucial for the correct diagnosis and starting treatment&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The rare bone involvement reported in cases of ATL and proven infection by <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#44; as well as the radiological alterations suggestive of persistent chronic osteomyelitis in the radiological control&#44; suggest that the bone lesions observed in the present case were caused by contiguity from the secondary infection&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> However&#44; histopathological examination and culture of the bone lesion are necessary&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Despite its wide distribution in Brazil&#44; atypical presentations of ATL can make the diagnosis difficult&#46; Therefore&#44; the relevance of epidemiology and PCR in atypical lesions is highlighted&#44; as well as the importance of an early diagnosis&#44; so that sequelae or mutilations can be prevented&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financial support</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Authors&#39; contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Dina Fabr&#237;cio da Silva&#58; Approval of the final version of the manuscript&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sidharta Quercia Gadelha&#58; Approval of the final version of the manuscript&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Andr&#233;a de Souza Cavalcante&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Rosilene Viana de Andrade&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; participation in the writing of the histopathological report&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Jorge Augusto de Oliveira Guerra&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Alcidarta dos Reis Gadelha&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the case&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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                0 => array:1 [
                  "referenciaCompleta" => "bvsms&#46;saude&#46;gov &#91;Internet&#93;&#46; Minist&#233;rio da Sa&#250;de&#46; Secretaria de Vigil&#226;ncia em Sa&#250;de&#46; Departamento de Vigil&#226;ncia das Doen&#231;as Transmiss&#237;veis&#46; Manual de vigil&#226;ncia da leishmaniose tegumentar Bras&#237;lia &#40;DF&#41;&#58; Minist&#233;rio da Sa&#250;de&#59; 2017&#46; &#91;accessed 12 nov 2021&#93;&#46; Available from&#58; <a target="_blank" href="https://bvsms.saude.gov.br/bvs/publicacoes/manual_vigilancia_leishmaniose_tegumentar.pdf">https&#58;&#47;&#47;bvsms&#46;saude&#46;gov&#46;br&#47;bvs&#47;publicacoes&#47;manual&#95;vigilancia&#95;leishmaniose&#95;tegumentar&#46;pdf</a>&#46;"
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              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and epidemiological profiles of patients with American cutaneous leishmaniasis from the states of Pernambuco and Amazonas&#44; Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Melo"
                            1 => "R&#46; Morais"
                            2 => "T&#46;C&#46; Goes"
                            3 => "R&#46; Silva"
                            4 => "R&#46;F&#46; Morais"
                            5 => "J&#46; Guerra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Soc Bras Med Trop&#46;"
                        "fecha" => "2020"
                        "volumen" => "53"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and validation of PCR-based assays for diagnosis of American cutaneous leishmaniasis and identification of the parasite species"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;C&#46; Gra&#231;a"
                            1 => "A&#46;C&#46; Volpini"
                            2 => "G&#46;A&#46;S&#46; Romero"
                            3 => "M&#46;P&#46; de O&#46; Neto"
                            4 => "M&#46; Hueb"
                            5 => "R&#46; Porrozzi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0074-02762012000500014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mem Inst Oswaldo Cruz&#46;"
                        "fecha" => "2012"
                        "volumen" => "107"
                        "paginaInicial" => "664"
                        "paginaFinal" => "674"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22850958"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atypical presentations of cutaneous leishmaniasis&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;B&#46; Meireles"
                            1 => "L&#46;C&#46; Maia"
                            2 => "G&#46;C&#46; Soares"
                            3 => "I&#46;P&#46;P&#46; Teodoro"
                            4 => "M&#46; do S&#46;V&#46; Gadelha"
                            5 => "C&#46;G&#46;L&#46; da Silva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.actatropica.2017.05.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Trop&#46;"
                        "fecha" => "2017"
                        "volumen" => "172"
                        "paginaInicial" => "240"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28526427"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous leishmaniasis&#58; a great imitator"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;S&#46; Gurel"
                            1 => "B&#46; Tekin"
                            2 => "S&#46; Uzun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2019.10.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2020"
                        "volumen" => "38"
                        "paginaInicial" => "140"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32513395"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sporotrichoid cutaneous leishmaniasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Er-Rami"
                            1 => "H&#46; Lahlou"
                            2 => "S&#46; Benjelloun"
                            3 => "A&#46; Jakar"
                            4 => "A&#46; Khalloufi"
                            5 => "M&#46; El Haouri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.annder.2011.10.406"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol&#46;"
                        "fecha" => "2012"
                        "volumen" => "139"
                        "paginaInicial" => "171"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22325764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupoid leishmaniasis among the known cases of cutaneous leishmaniasis in Herat Province&#44; western Afghanistan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Pazoki"
                            1 => "M&#46; Fakhar"
                            2 => "A&#46; Rasooli"
                            3 => "M&#46; Karamian"
                            4 => "E&#46; Nazar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jiph.2015.12.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Public Health&#46;"
                        "fecha" => "2016"
                        "volumen" => "9"
                        "paginaInicial" => "557"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26796767"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Observa&#231;&#245;es &#243;sseas na leishmaniose cut&#226;neo difusa &#40;LCD&#41; no Estado do Maranh&#227;o"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;C&#46;R&#46; Saldanha"
                            1 => "T&#46;S&#46; Malheiros"
                            2 => "C&#46;C&#46;R&#46; Rodrigues"
                            3 => "I&#46;T&#46;A&#46; Balby"
                            4 => "J&#46;M&#46;L&#46; Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0037-86821995000100011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Soc Bras Med Trop&#46;"
                        "fecha" => "1995"
                        "volumen" => "28"
                        "paginaInicial" => "55"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7724870"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Article information
ISSN: 03650596
Original language: English
DOI:10.1016/j.abd.2022.04.014
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