Paniculite eosinofílica pode ser desencadeada por muitos fatores; aqui os autores descrevem a síndrome em conseqüência de injeções intramusculares de compostos de antimônio para tratamento de leishmaniose tegumentar americana em três pacientes. Todos eles desenvolveram lesões em placa, profundamente infiltradas, no local da injeção antimonial. A histopatologia mostrou acentuado infiltrado inflamatório da hipoderme com numerosos eosinófilos. O estudo imunológico não demonstrou imunoglobulinas ou frações do complemento nas lesões. O diagnóstico final foi de paniculite eosinofílica ocorrendo como efeito colateral da terapia antimonial. O mecanismo patogênico dessa paniculite não pôde ser definido. As hipóteses sugeridas foram de lesão induzida por fenômeno físico - a pressão exercida pelo volume do líquido injetado - ou de uma reação alérgica ao antimônio.

Eosinophilic panniculitis may be induced by several triggering factors and this syndrome is described here following the intramuscular injection of antimonial compounds for treatment of American muco-cutaneous leishmaniasis. Three patients, treated with intramuscular injections of pentavalent antimony (Glucantime®) were studied through clinical examination, histopathology and immunologic methods. The three patients developed deep infiltrated plaques at the site of antimony injection. Histopathology disclosed a prominent inflammatory infiltrate of the subcutaneous fat with numerous eosinophils. Immunologic studies could not detect immunoglobulins or complement fractions in the lesions. The final diagnosis was eosinophilic panniculitis occurring as a side-effect of antimonial therapy. The pathogenesis was not clear and it is suggested that the disease could be induced by a physical factor such as pressure or an immunological reaction to antimony.

The authors report a case of culture-proven disseminated American muco-cutaneous leishmaniasis caused by Leishmania brasiliensis brasiliensis in an HIV positive patient. Lesions began in the oropharynx and nasal mucosa eventually spreading to much of the skin surface. The response to a short course of glucantime therapy was good.