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Paronychia-like cutaneous leishmaniasis

Abstract

Chronic paronychia is an inflammatory recalcitrant disorder affecting the nail folds. We report one patient with paronychia  revealing ungueal leishmaniasis.

A 34-year-old man, resident in the north of Morocco, presented with a 6-month history of an inflamed proximal nail fold of  the left thumb, resistant to antibiotics and anti-fungal treatments.

En bloc excision of the proximal nail fold was done. The histopathological exam showed epithelioid  granulomas  with giant  cells and the presence of  leshmania  amastigotes, leading to the diagnosis of ungueal leishmaniasis.

Clinical aspects of cutaneous leishmaniasis can be very misleading. The paronychial form is rarely described. In endemic areas  it is necessary for the physician to be aware of atypical skin presentations of  leishmaniasis.

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