Dermatofibroma parasitized by Leishmania in HIV infection: a new morphologic expression of dermal Kala Azar in an immunodepressed patient

Visceral leishmaniasis is a protozoan infection that may complicate the cou rse of patients with human immunodeficiency virus (HIV). Dermatofibroma is a cutaneous fibrohistiocytic lesion considered neoplastic by some authors a nd inflammatory by others. Eruptive dermatofibromas have been described in patients with HIV infection or with other altered immunity situations. We p resent the case of a 32-year-old, HIV-positive man with visceral leishmania sis who complained of the appearance of a cutaneous lesion in the leg forme d by the coexistence of dermatofibroma and Leishmania parasitic colonizatio n. As far as we know, this type of association has not been reported previo usly. We consider that the dermatofibroma could have developed as an unusua l form of fibrohistiocytic reaction to leishmania. From a practical approac h, we recommend the search of leishmaniasis in dermatofibroma in immunosupr essed patients.