Figure 1: An ulcerated lesion appeared on the scrotal region of a Brazilian 50-year-old male patient from Goiás, Midwestern region. After one month, ulcerated lesions spread to the trunk, face, nasal mucosa, and upper limbs. Lower limbs were affected presenting bleeding and papular lesions. Histopathological analysis suggested Leishmania infection and the patient was tested HIV positive. Biopsy fragment from one cutaneous lesion was used to perform H&E and immunohistochemistry (IHC) stainings. (A) Panoramic view of the lesion, showing severe inflammatory process with mononuclear cells in upper and lower layers of the dermis (H&E, 200×). (B) Parasitophorous vacuoles in macrophages with rounded structures, suggestive of amastigotes, adhered to the membranes (H&E, 200×). (C) IHC detection of CD68+ macrophages (IHC, 200×). (D) CD3+ T lymphocytes (IHC, 40×). (E) CD20+ B lymphocytes (IHC, 40×). (F) Amastigotes (IHC, 400×). The inset presents amastigote in detail showing nucleus and kinetoplast (1 000×).