Efficacy of fluconazole therapy for cutaneous leishmaniasis. A case report and review of literature.

Cutaneous Leishmaniasis is endemic in the western province of Libya, including the Zliten countryside, despite its self-limited nature, many cases may run a chronic course and resist ordinary treatment, causing disfigurement or even deformity. Our case is a 47-year-old black Libyan man presented to us 2 years ago, with an ulcerated plaque in his left leg and infiltrated plaque in his right ear due to cutaneous leishmaniasis. While the leg ulcer healed with a small scar after a 6-week course of intra-lesional sodium stibogluconate, the lesion on the ear failed to heal by local treatment. Furthermore, parenteral antimony was stopped by a cardiologist. By time, nodules had developed inside the infiltrated lesion. After 18 months, the case was reevaluated by skin slit smear and histopathology, which both showed amastigotes in the lesion. We tried 150 mg of fluconazole daily for 45 days after appropriate investigations. Unfortunately, without success. Our paper details the clinical, parasitological and pathological findings of this case, in addition to literature review on the efficacy of oral fluconazole in treating cutaneous leishmaniasis