Post-kala-azar dermal leishmaniasis mimicking leprosy: experience with 4 patients, with some unusual features in 1.
We report on 4 cases of post-kala-azar dermal leishmaniasis (PKDL). History of kala-azar was available in all 4 patients. Slit-skin smears (SSS) for leishmania donovani (LD) bodies were negative in all 4. In 3 patients hypopigmented lesions were present over the face. Papules and nodules over his lips, tongue, scrotum and dactylitis were some unusual features observed in 1 patient. Histopathological examination showed LD bodies in 2 patients; histopathology was nonspecific in the other 2. All the patients were treated with sodium stibogluconate, 20 mg/kg/day. Infiltrated papules and nodules had subsided by 3 months, while hypopigmented macules took longer to improve. In 3 patients there had previously been a misdiagnosis as leprosy sufferers and they had been treated with antileprosy drugs. Clinical and histopathological differences between PKDL and leprosy are discussed.
Dhar
S
S
Department of Dermatology, PGIMER, Chandigarh, India.
Kaur
I
I
Dawn
G
G
Sehgal
S
S
Kumar
B
B
D000328:Adult; D000818:Animals; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007893:Leishmania donovani / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007918:Leprosy / Q000175:diagnosis*; D008297:Male
D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate