Human Subcutaneous Dirofilariasis due to Dirofilaria (Nochtiella) repens: Clinically Suspected as Cutaneous Fascioliasis

The significant increase in the number of human subcutaneous dirofilariasis in recent years, suggests the appear­ance of a new health problem in the old world with most cases reported from Mediterranean countries. Besides the pre­sent case, eleven cases of human subcutaneous dirofilariasis have been detected in Iran, three of which belong to Gilan Prov­ince, northern Iran. We present an autochthonous case of subcutaneous Dirofilaria repens infection in a 39-year-old woman from Kouches­fahan district of Gilan Province, manifest as an itching and highly erythmatous subcutaneous tender nodule on her right thigh. The nodule was excised by a dermatologist as a suspected case of cutaneous fascioliasis. Microscopic examination of the excised nodule revealed the presence of D. repens. Since Gilan Province is the endemic region for human fascioliasis and several cases of cutaneous fascioliasis have been detected in the province during last two decades, we propose the physicians and pathologists to take in to account sub­cutaneous dirofilariasis as an emergent zoonosis causing dermal and visceral lesions which may sometimes misdiagnose as malignant tumors, and also as differential diagnosis of cutaneous fascioliasis.