A 26-year-old man from Bihar comes with juicy look¬ing papules over face and back of neck, which were hypopigmented and normoaesthetic. History revealed an episode of prolonged fever in childhood. Diagnosis:
A. Tuberculoid leprosy
B. Lepromatous leprosy
C. Post Kala Azar dermal leishmaniasis
D. Histoid Hansen’s
Ans: C. Post Kala Azar dermal leishmaniasis
(Ref Harrison 19/e p1391)
- Here the diagnosis = Post Kala-Azar dermal Leishmaniasis.
“Post Kala-Azar Dermal Leishmaniasis:
- On Indian subcontinent, Sudan & other East African countries:
- 2-50% of patients develop skin lesions concurrent with or after cure of visceral leishmaniasis.
Most common skin lesions:
- Hypopigmented macules, papules, and/or nodules or diffuse infiltration of skin & oral mucosa.
- History of kala-azar in past (1-5 years ago) or living in endemic area.
- Presence of “juicy” erythematous nodules on central part of face.
- Hypopigmented macules on central part of trunk.
- No nerve involvement.