International Journal of Clinical & Medical Images

Cutaneous leishmaniasis caused by leishmania tropica in Bam, Iran1. On 26th of December 2003 a disastrous earthquake occurred at Bam. After this disaster an epidemic of cutaneous leishmaniasis occurred in this region.

Negative smear for a small lesion, specially in rural area was one of big challenges for a medical doctor to satisfy the patients or their parents that clinical impression in epidemic area of C.L is more acceptable than negative smear.

This case report explained, on 2005 a one year old girl referred to the skin clinic in Bam city with her parents because of having a small red papule on the nose (Fig.1). Negative smear (only accessible para-clinical test at that time), pursued her paraents to deny the diagnosis of C.L which was made by doctor as well as his recommendation to treat the lesion by Glucantim injection.

Four months later, they came back to the clinic while the small papule on the nose changed to the big plaque on the nose, face, and near to right lower eyelid (Figure 2). Patient’s father confess to his mistake and promised to undertake any doctor’s recommendation.

Patient went under treatment with systemic injection of Glucantim and crayothrapy on 2006 for 3 weeks (Figure 3). patient cured with small atrophic scar, due to one year follow up on 2007 (Figure 4).

Conclusion: some times education and showing strong document and pictures like this case, would be very effective to satisfy those patients and parents who may not accept the dianosis and advice of doctor because of having unreliable paraclinical result.

Corresponding author
Guadalupe Garcia-Elorriaga
Hospital de Infectología
Mexico