C. Cutaneous leishmaniasis
Histopathologic findings revealed a diffuse dermal inflammatory infiltrate consisting of lymphocytes, plasma cells, small epithelioid granulomas (Figure, C), and histiocytes containing leishmania amastigotes (Figure, D). Given the clinical and histopathologic findings, a diagnosis of cutaneous leishmaniasis was made, and because the patient had only 1 lesion, treatment with intralesional meglumine antimoniate was initiated. Improvement and resolution of the lesion were observed after 2 infiltrations with no adverse effects.
Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly.1 In Spain, cutaneous leishmaniasis caused by Leishmania infantum is common, especially in endemic areas mainly located on the Mediterranean coast.2 Because of the enhanced opportunity for exposure and possibly not having a fully developed immune system, children may be more susceptible to infection than adults3 and constitute 7% to 10% of cases in endemic regions.4