Diagnosis: Leishmaniasis, sandfly
"This photograph depicts a Phlebotomus papatasi sandfly, which had landed atop the skin surface of the photographer, who’d volunteered himself as host for this specimen’s blood meal. The sandflies are members of the Dipteran family, Psychodidae, and the subfamily Phlebotominae. This specimen was still in the process of ingesting its bloodmeal, which is visible through [ ]
"This photograph depicts a Phlebotomus papatasi sandfly, which had landed atop the skin surface of the photographer, who’d volunteered himself as host for this specimen’s blood meal. The sandflies are members of the Dipteran family, Psychodidae, and the subfamily Phlebotominae. This specimen was still in the process of ingesting its bloodmeal, which is visible through its distended transparent abdomen. Sandflies such as this P. papatasi, are responsible for the spread of the vector-borne parasitic disease Leishmaniasis, which is caused by the obligate intracellular protozoa of the genus Leishmania. This image is in the public domain and thus free of any copyright restrictions. As a matter of courtesy we request that the content provider be credited and notified in any public or private usage of this image." Content provider: CDC/ Frank Collins"
Non-healing ulcer with raised borders at site of sandfly bite. Travel to endemic areas (Middle East, Central/South America, Mediterranean, Africa). Duration of lesion.
Old World (small, single): observation for spontaneous healing, cryotherapy, intralesional antimony. L. braziliensis (mucocutaneous risk): systemic therapy essential — liposomal amphotericin B, miltefosine, or sodium stibogluconate.
• Squamous cell carcinoma • Basal cell carcinoma • Lupus vulgaris (cutaneous TB) • Sporotrichosis • Foreign body granuloma • Sarcoidosis • Keratoacanthoma
• 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: sandfly