Cutaneous leishmaniasis: Report of a clinical case from the Ecuadorian Amazon

Abstract

Leishmaniasis is a vector-borne zoonosis caused by various protozoa of the genus Leishmania. Although the environmental and climatic factors that favor its transmission are well documented, it is also important to highlight that social factors such as poverty and malnutrition play a significant role in its epidemiology. The clinical and epidemiological relevance of this disease motivates the presentation of cases that help improve its diagnosis and management. In this context, we report the case of a 4-year-old boy from an endemic area in the province of Zamora Chinchipe, Ecuador. The child presented with three papule-shaped lesions with indurated, pruritic, and scaly edges, approximately 5 mm in diameter, located on the back of the right arm. These lesions began as small papules and, over time, evolved into ulcers that increased in size. The persistence of the lesions despite combined treatment with antifungal and antibacterial agents raised the clinical suspicion of cutaneous leishmaniasis, especially considering that the patient was from an area endemic for this disease. To confirm the diagnosis, a smear of the lesions was performed, which identified the presence of the protozoan Leishmania, thus establishing cutaneous leishmaniasis. Treatment with antimony salts led to gradual resolution of the lesions, demonstrating the efficacy of this therapy in these cases. This case highlights the importance of early diagnosis and adequate follow-up, as this helps prevent systemic complications and the involvement of other organs. Ultimately, this case report underscores the need to consider leishmaniasis in patients from endemic areas who present with persistent cutaneous lesions, allowing for timely and effective management.