Page 101 - GTM-3-1

Global Translational Medicine

CASE REPORT
Anergy as a potential risk factor for squamous

cell carcinoma in an immunocompetent patient
with diffuse cutaneous leishmaniasis: A case

report

1
2
Andrés Tirado-Sánchez *, Alexandro Bonifaz , and Sebastián Hernández-Gómez 1
1 Department of Internal Medicine, Hospital General de Zona 30, Instituto Mexicano del Seguro
Social, Mexico City, México
2 Mycology Laboratory, Hospital General de México, Mexico City, México

Abstract

Despite the rarity, leishmaniasis may occur in tandem with malignancy. This
co-occurrence contributes to a postulation that anergy to parasite antigens
may predispose an infected patient to the development of diffuse cutaneous
leishmaniasis and also increase the risk of developing squamous cell carcinoma
due to decreased host immune response. We, herein, present a 63-year-old man
suffering diffuse cutaneous leishmaniasis that was poorly responsive to treatment.
Furthermore, the patient had several nodule-like, infiltrative, and coalescent lesions
on his right face. The Montenegro skin test revealed signs of anergy and the biopsy
test revealed squamous cell carcinoma (SCC) coexisting with Leishmania sp. bodies.
*Corresponding author:
Andrés Tirado-Sánchez The patient was given a treatment with amphotericin B and later with radiation
(Andres.tiradosa@anahuac.mx) therapy, but the tumors showed a poor response to the treatment, and the patient
Citation: Tirado-Sánchez A, was lost on follow-up. Our observations of the current case highlight the role of a
Bonifaz A, Hernández-Gómez S. weakening host immune response as a result of diffuse cutaneous leishmaniasis
Anergy as a potential risk factor in the development of SCC. Such postulation points to and corroborates the
for squamous cell carcinoma in
an immunocompetent patient with involvement of anergy, a condition probably caused by parasite-induced
diffuse cutaneous leishmaniasis: suppression of the immune response, linking leishmaniasis, and skin malignancy
A case report. Global Transl Med. development.
2024;3(1):2281.
https://doi.org/10.36922/gtm.2281
Received: November 20, 2023 Keywords: Leishmaniasis; Squamous cell carcinoma; Anergy; Immunosuppression
Accepted: January 24, 2024
Published Online: March 20, 2024
Copyright: © 2024 Author(s).
This is an Open Access article 1. Background
distributed under the terms of the
Creative Commons Attribution Leishmaniasis is caused by obligate intracellular parasites of the Leishmania genus.
1
License, permitting distribution,
and reproduction in any medium, There are more than 20 species of Leishmania, mainly found in animals, which can be
2
provided the original work is transmitted to humans by sandflies (Phlebotomus spp. or Lutzomyia spp.). Inoculation
properly cited. is deployed to control the replication of the parasite in the majority of cases, who would
3
Publisher’s Note: AccScience still harbor strands of the parasite despite the lack of relevant symptoms. Reactivation
Publishing remains neutral with of the parasite and re-infection can occur during immunosuppression or in the absence
regard to jurisdictional claims in
published maps and institutional of overt immunosuppression, in conditions such as T-cell deficiency and delayed-type
affiliations. hypersensitivity reactions with parasite anergy. 4,5

Volume 3 Issue 1 (2024) 1 https://doi.org/10.36922/gtm.2281