Conflicts of interest: None declared.
Tropical Medicine Rounds
Post-kala-azar dermal leishmaniasis mimicking leprosy relapse: a diagnostic dilemma
Article first published online: 10 DEC 2013
© 2013 The International Society of Dermatology
International Journal of Dermatology
Volume 53, Issue 5, pages 606–608, May 2014
How to Cite
Arora, S., D'Souza, P., Haroon, M. A., Ramesh, V., Kaur, O. and Chandoke, R. K. (2014), Post-kala-azar dermal leishmaniasis mimicking leprosy relapse: a diagnostic dilemma. International Journal of Dermatology, 53: 606–608. doi: 10.1111/ijd.12299
- Issue published online: 23 APR 2014
- Article first published online: 10 DEC 2013
Post-kala-azar dermal leishmaniasis (PKDL) is well recognized in the Indian subcontinent and is not infrequently confused with leprosy. The present report describes findings in an unusual case of PKDL.
We report an adult male who presented with firm nodules on the face and extremities, along with hypopigmented macules on the neck with deformity and hypoesthesia over the right upper extremity. The patient had experienced similar lesions seven years previously and had used multibacillary multi-drug therapy for leprosy with complete resolution of the nodules.
At the current presentation, skin smears from ear lobes and nodules were negative on Ziehl–Neelsen staining. Histopathological examination revealed a dermal lymphohistiocytic infiltrate with plasma cells. Giemsa staining of a tissue smear revealed Leishmania donovani bodies, and an rK39 antigen test was positive. The patient responded well to oral miltefosine.
This case is noteworthy because the patient exhibited an unusual combination of healed leprosy sequelae and active PKDL lesions, which caused a diagnostic dilemma.