[hermantheshocker]

Turkey. A 52-year-old Syrian presented to the dermatology department at Hatay Mustafa Kemal University with complaints of facial lesions and purulent rhinitis for 3 months. He also had vitiligo for 20 years, a condition in which the skin loses its pigment cells. The patient had no history of smoking, alcohol consumption or systemic disease.


Fig.1 Massively crusted, granulomatous plaques on the central and lower face.

Dermatologic examination revealed crusted and infiltrated granulomatous plaques on the anterior upper surface and side of the nose, cheeks and lower and upper lips with purulent discharge (Fig.1). The lesions had affected the anterior nasal septum and columella. Nasal examination showed mucopus in the nasal cavity, loss of tissue on the columella and cartilage necrosis on the anterior nasal septum and consequently, loss of tip support. In addition, depigmented macules of vitiligo were noted on the face and extremities. General physical examination was normal. Laboratory tests were within normal limits. HIV and hepatitis C tests were negative.

Findings from histopathologic examination were suggestive of mucocutaneous leishmaniasis but no parasite was seen. On the basis of history, clinical and histopathological findings and skin smear results, mucocutaneous leishmaniasis was diagnosed. The patient was treated with systemic meglumine antimoniate, 20 mg/kg/day intramuscularly, in 2 divided doses for 30 days. The lesions improved dramatically 1 month after the treatment (Fig.2).


Fig.2 Significant improvement 1 month after the treatment.

Mucocutaneous leishmaniasis is a serious and potentially life-threatening form of the disease. It is often perceived as a New World disease almost only found in South America but rarely seen in the Old World. Early diagnosis and appropriate treatment of mucocutaneous leishmaniasis is essential as there is a risk of extension of the disease and destruction of facial structures such as the nose, palate and buccal mucosa with potentially fatal pharyngeal and laryngeal involvement.
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This post is for educational purposes only and is nonprofit. Under Section 107 of the Copyright Act of 1976; Allowance is made for "Fair Use" for purposes such as criticism, comment, satire, news reporting, teaching, scholarship, and research. No copyright infringement intended. Images have been upscaled and sharpened/enhanced. Some of the text might have been shortened and simplified, and/or reorganized for online view. Original case report by Ekiz O., Kahraman Ş., Şen B.B., Serarslan G., Rifaioğlu E.N., Culha G., Özgür T. - Indian Journal of Dermatology 2017.

[kellyhound]

what a difference in 1 month as that would drive me crazy looking like that

[Izumi]

Holy shit.

[corpsehands]

I thought my beard itched...

[ChristySD]

You know that had to taste NASTY. I’m gagging just looking at pic #1. Herman, you always have the best medical shit!! Sure beats the JAMA from my pre-med days!!!!

[hermantheshocker]

Originally Posted by ChristySD ↗

You know that had to taste NASTY. I’m gagging just looking at pic #1. Herman, you always have the best medical shit!! Sure beats the JAMA from my pre-med days!!!!

Thank you

[shauns26]

Just needs to shave that monobrow, and he'll be a looker.

[xCellarxDoorx]

I wonder if He was given Accutane? Or something else.

[tschoga]

Albino

[herbertstencil]

My guy...you waited THREE MONTHS? Fuckouttahere