{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:16:34Z","timestamp":1790615794859,"version":"4.1.0"},"reference-count":14,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,18]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    Cutaneous leishmaniasis (CL) caused by the\n                    <jats:italic>Leishmania donovani<\/jats:italic>\n                    complex is uncommon in Europe and can masquerade as malignancy. We describe an immunocompromised man in his 70s with a 15-year verrucous plaque on the right hallux initially suspected as squamous cell carcinoma. Histology revealed macrophages packed with amastigotes; PCR confirmed\n                    <jats:italic>L. donovani<\/jats:italic>\n                    complex infection and serology was strongly positive. Staging excluded mucosal and visceral disease. Systemic liposomal amphotericin B achieved partial regression. Because of persistent hyperkeratosis and the acral site, adjuvant methyl-aminolevulinate photodynamic therapy (MAL-PDT) was added and was well tolerated. One month after the final session, the lesion showed near-complete re-epithelialisation with functional recovery. This case underscores the importance of early biopsy in atypical CL and suggests that MAL-PDT may be a useful adjuvant to amphotericin B in complex CL caused by the\n                    <jats:italic>L. donovani<\/jats:italic>\n                    complex.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-270149","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:30:57Z","timestamp":1790613057000},"page":"e270149","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Localised cutaneous leishmaniasis in an immunosuppressed host: the role for adjuvant photodynamic therapy after incomplete amphotericin B response"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7714-4318","authenticated-orcid":false,"given":"David Gaspar","family":"Caetano","sequence":"first","affiliation":[{"name":"Dermatology Department, Unidade Local de Sa\u00fade de Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Pedroso","sequence":"additional","affiliation":[{"name":"Dermatology Department, Unidade Local de Sa\u00fade de Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4157-4652","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Dermatology Department, Unidade Local de Sa\u00fade de Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Carlos","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Dermatology Department, Unidade Local de Sa\u00fade de Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Manuel","family":"Brites","sequence":"additional","affiliation":[{"name":"Dermatology Department, Unidade Local de Sa\u00fade de Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Dermatology Department, Unidade Local de Sa\u00fade de Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"2026092809300997000_19.9.e270149.1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw742"},{"key":"2026092809300997000_19.9.e270149.2","unstructured":"Pan American Health Organization . Guideline for the treatment of leishmaniasis in the Americas. 2nd edn. 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