A 39-year-old patient, who travels 2 years ago to a desert area in south-eastern Morocco, presented with an ulcerous and crusty plaque on his left leg. The clinical exam founds numerous, ulcerous and crusty nodules, confluent to form a plaque of about 5 cm long (Figure 1A), painless with some smaller satellite lesions (arrows) arranged on sporotrichoïd pattern (Figure 1B). Parasitological examination found numerous amastigotes within mononuclear cells and pathology shows a granulomatous infiltrate thus establishing the diagnosis of leishmaniasis. Leishmaniasis is a parasitic disease due to a flagellated protozoan belonging to the genera Leishmania, transmitted by female sandflies from the genera Phlebotomus in the "Old World". The sporotrichoïd pattern is explained by the lymphatic spreading of the infection and always requires systemic treatment like our patient, whom been treated with intramuscular injections of meglumine antimoniate with complete healing of the lesions 12 weeks after [1,2].
Figure 1: A) The clinical exam founds numerous, ulcerous and crusty nodules, confluent to form a plaque of about 5 cm long; B) Painless with some smaller satellite lesions (arrows) arranged on sporotrichoïd pattern.