CUTANEOUS LEISHMANIASIS

Diagnosis: CUTANEOUS LEISHMANIASIS

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted October 7, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Squamous cell carcinoma • Basal cell carcinoma • Lupus vulgaris (cutaneous TB) • Sporotrichosis • Foreign body granuloma • Sarcoidosis • Keratoacanthoma

Key Learnings

• Caused by Leishmania parasites transmitted by phlebotomine sandfly bite • Three main forms: cutaneous (most common), mucocutaneous, visceral (kala-azar) • Cutaneous: painless papule → nodule → ulcer with raised borders at bite site • Old World CL (L. major, L. tropica): tends to self-heal in 6-12 months • New World CL (L. braziliensis): risk of mucocutaneous disease — nasal/oral destruction • Amastigotes (Leishman-Donovan bodies) seen within macrophages on Giemsa stain • Diagnosis: touch prep/smear, PCR, culture (NNN medium), skin biopsy

Tags: cutaneous, leishmaniasis, dr.azeem alam khan