Unusual cutaneous lesions in two patients with visceral leishmaniasis and HIV infection

Two HIV infected patients with visceral leishmaniasis and unusual cutaneous lesions are described. The first patient developed linear brown macules co ntaining Leishmania parasites on the fingers and palms of the hands. This p atient never received highly active antiretroviral treatment and the viscer al leishmaniasis could not be cured even with liposomal amphotericin. In th e second patient, Leishmania parasites were present in a skin biopsy of a f ibrous histiocytoma. After completing visceral leishmaniasis treatment, a d iscrete elevation of one of his tattoos was seen. A biopsy specimen of this tattoo revealed Leishmania amastigotes. In this patient the visceral leish maniasis was finally cured with meglumine antimoniate, followed by pentacar inat isothianate as maintenance therapy in conjunction with highly active a ntiretroviral treatment.