Disseminated cutaneous leishmaniasis: ulcerovegetative and ulcero-crusted lesions.

69-year-old male patient, with history of multiple furunles for two months, without improvement after the use of ephalexin and amoxicillin/clavulanate for 20 days, and daily ever for a week. On dermatological examination, multiple lcerovegetative and ulcero-crusted cutaneous lesions on the ace, ears, scalp, back, upper and lower limbs and genitalia ere observed (Figs. 1 and 2). There was no lymphadenopathy. ased on the clinical picture the hypotheses of dissemiated cutaneous leishmaniasis, paracoccidioidomycosis, and alignant syphilis were raised. Laboratory tests (blood count, enal function, hepatography, and coagulogram) were normal. erology for hepatitis, syphilis, HIV, and Leishmania donovani ere negative. Swabs taken from open lesions for direct mycologcal examination and culture for fungi were negative. istopathological of the edge of an ulcer on the dorsum emonstrated dense lymphohistiocytic inflammatory infilrate with plasma and mast cells, in addition to neutrophils nd granuloma formation; hyperplastic skin surrounded with