<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022016000200081</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Leishmanasis mucocutánea tratada con miltefosine]]></article-title>
<article-title xml:lang="en"><![CDATA[Mucocutaneous leishmaniasis treated with miltefosine]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Yu-Tseng]]></surname>
<given-names><![CDATA[Fulin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta-Valerín]]></surname>
<given-names><![CDATA[Roy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense de Seguro Social Servicio de Dermatología del Hospital de Grecia ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Caja Costarricense de Seguro Social Servicio de Otorrinolaringología del Hospital &#8220;Dr. Rafael Ángel Calderón Guardia&#8221; ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>58</volume>
<numero>2</numero>
<fpage>81</fpage>
<lpage>83</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022016000200081&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022016000200081&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022016000200081&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El miltefosine (Impávido®) es un medicamento de componente antineoplásico que ha encontrado efectividad muy alta contra la leishmaniasis mucocutánea y visceral en el mundo, y se ha convertido en una opción muy atractiva para pacientes con enfermedades de fondo y tratamientos de base que contraindican el uso de amoniato de meglumina (Glucantime®) o stibogluconato de sodio (Pentostam®). Seguidamente se presenta el caso de un paciente de 78 años con antecedentes de diabetes mellitus tipo 2, hipertenso, anticoagulado con warfarina por una fibrilación auricular crónica, que inició una dermatosis ulcerosa de bordes violáceos elevados, única en el hélix del oído derecho, de evolución crónica asociada a múltiples ulceraciones en la mucosa nasal. La biopsia cutánea se reportó como inespecífica, pero como la sospecha clínica era alta de leishmaniasis, se realizó una reacción de cadena polimerasa de tejido de mucosa nasal que fue reportada positiva por Leishmania panamensis. Por las comorbilidades y el tratamiento del paciente se decidió tratarlo con miltefosine (Impávido®).]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Miltefosine (Impavido®) is an anticancer medicine that has been found highly effective against mucocutaneous and visceral leishmaniasis worldwide, making it a very attractive option for patients with underlying diseases and treatments that contraindicate the use of glucamine antimoniate (Glucantime®) or sodium stibogluconate (Pentostam®). Here we present the case of a 78 years old male, with a history of type 2 diabetes mellitus, high blood preasure, anticoagulated with warfarin for chronic atrial fibrillation, who started with a solitary cutaneous ulcer of purplish edges on the right ear helix of chronic evolution associated with multiple ulcerations on the nasal mucosa. Skin biopsy was reported as nonspecific, but as clinical suspicion of leishmaniasis was high, a polymerase chain reaction of nasal mucosa tissue was performed for Leishmania with positive results for Leishmania panamensis. Due to comorbidities and the treatment of our patient we decided to use miltefosine (Impavido®) for 2 months with very good results.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[leishmaniasis mucocutánea]]></kwd>
<kwd lng="es"><![CDATA[amoniato de meglumina]]></kwd>
<kwd lng="es"><![CDATA[stibogluconato de sodio]]></kwd>
<kwd lng="es"><![CDATA[Glucantime®, Pentostam®]]></kwd>
<kwd lng="es"><![CDATA[mitelfosine]]></kwd>
<kwd lng="es"><![CDATA[Impávido®.]]></kwd>
<kwd lng="en"><![CDATA[Mucocutaneous leishmaniasis]]></kwd>
<kwd lng="en"><![CDATA[Meglumine antimoniate (glucantime)]]></kwd>
<kwd lng="en"><![CDATA[Miltefosine (Impavido)]]></kwd>
<kwd lng="en"><![CDATA[sodium stibogluconate (Pentostam)]]></kwd>
<kwd lng="en"><![CDATA[PCR (polymerase chain reaction).]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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