Anergy as a potential risk factor for squamous cell carcinoma in an immunocompetent patient with diffuse cutaneous leishmaniasis: A case report

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. The patient was given a treatment with amphotericin B and later with radiation therapy, but the tumors showed a poor response to the treatment, and the patient was lost on follow-up. Our observations of the current case highlight the role of a weakening host immune response as a result of diffuse cutaneous leishmaniasis in the development of SCC. Such postulation points to and corroborates the involvement of anergy, a condition probably caused by parasite-induced suppression of the immune response, linking leishmaniasis, and skin malignancy development.