A CASE OF GRANULOMATOUS DERMATITIS - CUTANEOUS LEISHMANIASIS

A case is reported of a 75-year-old woman, with a past clinical histor y of granuloma annulare, who developed groups of papulonodular skin le sions on the trunk and face six weeks after returning from a trip to t he Mediterranean. The initial biopsy showed a granulomatous dermatitis which was considered consistent with the sarcoidal variant of granulo ma annulare, and the lesions were treated with topical and intralesion al steroid. A second biopsy performed four months later revealed large numbers of histiocytes containing diagnostic Leishman bodies. It is n ot clear whether the first biopsy was from a chronic lesion and the se cond from an acute lesion, or whether local steroid treatment enhanced proliferation of organisms and made a definitive diagnosis possible o n the second biopsy.