Contact dermatitis-like cutaneous leishmaniasis in a Libyan HIV patient

Background: cutaneous leishmaniasis (cl) is one of the common tropical protozoal diseases caused by various leishmania species,and transmitted by the sand-fly vectors,phlebotomus and lutzomyia species. herein,we report for the first time a case of cl that presented as large eczematous plaques occurring on the dorsi of both feet in a libyan drug addicted,alcoholic patient with hiv infection.findings. a 34 year-old hiv-positive,alcoholic,drug addicted libyan male presented to us with a history of a non-itchy skin lesions on the dorsi of both feet of 5-weeks duration. systemic and topical antibiotics were given without improvement. diagnosis of this patient was confirmed by observation of leishmania amastigote bodies in stained slit-skin smear skin biopsy. after parenteral administration of sodium stiboglyconate (pentostam) (20 mg/kg/day) for 28 days the lesions did not show any marked improvement. concurrently,combination therapy of oral rifampicin (600 mg/day) and isoniazide (300 mg/day) was given for 8 weeks. complete healing of lesions was achieved after this treatment and skin-slit smears turned negative.conclusions: localized cutaneous leishmaniasis should be remembered in deferential diagnosis of unresponsive contact dermatitis especially for hiv-positive patients in cl endemic areas.this patient was not responding to pentostam therapy,which is not very common in libya. interestingly,combination of oral rifampicin (600 mg/day) and isoniazide (300 mg/day) can be a successful alternative therapy. © 2014al-dwibe et al.; licensee biomed central ltd.