Indexed with PubMed and Science Citation Index (E) 
Users online: 2512 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
   Next article
   Previous article 
   Table of Contents
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

  In this article
    Case Report

 Article Access Statistics
    PDF Downloaded0    
    Comments [Add]    
    Cited by others 3    

Recommend this journal

Year : 2002  |  Volume : 68  |  Issue : 3  |  Page : 145-146

Unusual presentation of cutaneous leishmaniasis

Department of Dermatology, Bukayriyah General Hospital, Bukayriyah, Gassim, Saudi Arabia

Correspondence Address:
H No: 1-20-23, Venkatapuram, Trimulghery, Secunderabad-15, Andhra Pradesh, Saudi Arabia


Cutaneous leis hmaniasis is endemic in some regions of Saudi Arabia. A case with uncommon hyperkeratotic type of lesion was seen. Being an endemic zone, a slit- skin smear was done and stained with Giemsa's stain. Smears howed Leishman Donovan bodies within and outside the macrophages. Significant improvement, followed by complete resolution of the lesion was seen with ketoconazole treatment.

How to cite this article:
Lahiry A. Unusual presentation of cutaneous leishmaniasis. Indian J Dermatol Venereol Leprol 2002;68:145-6

How to cite this URL:
Lahiry A. Unusual presentation of cutaneous leishmaniasis. Indian J Dermatol Venereol Leprol [serial online] 2002 [cited 2020 Dec 4];68:145-6. Available from:

   Introduction Top

Cutaneous leishmaniasis is the most common type of leishmaniasis present in the kingdom of Saudi Arabia. The most important factor is that cutaneous leishmaniasis is protean in its manifestation and may mimic many other pathological skin conditions. The first step is to maintain a high index of suspicion for this disorder, when a native resident develops a nonhealing skin lesion of 2 or more week's duration[1] on exposed sites. One criteria to confirm the diagnosis is to demonstrate the parasites in the lesions.

   Case Report Top

A 36- year-old Pakistani male presented to Dermatology clinic with a thick verrucous plaque over lateral aspect of left leg of two months duration. On examination a 4 inch by 3 inch indurated violaceous-red plaque with papillomatous surface was seen over the lateral aspect of left leg [Figure - 1]. The lesion was asymptomatic. Tuberculosis verrucosa cutis was suspected initially because of its verrucous appearance, its presence over exposed area and the patient being of Asian subcontinent origin. But being in an area where cutaneous Leishmaniasis is endemic a slit- skin smear was taken from the edge of the lesion before a biopsy could be taken. Giemsa's stain of the smear showed numerous Leishman Donovan bodies within the macrophages along with few lymphocytes, this clinched the diagnosis.
The patient was put on oral ketoconazole 400mg/day for eight weeks. By four weeks the lesion started flattening and two weeks after stopping the therapy complete resolution was seen [Figure - 2].

   Discussion Top

The case is being discussed because of its uncommon morphological feature and its resemblance to cutaneous tuberculosis. The clinical diagnosis in this patient was suspected because of being in endemic zone, which was later confirmed by a slit- skin smear.
The different clinical types of cutaneous leishmaniasis represented different species affection, like the ulcerated wet type of rural lesions are produced by L. major, the dry urban type of lesions are produced by L. tropica and diffuse cutaneous leishmaniasis by L. aethiopica. In Leishmaniasis recidivans usually lupoid like lesions develop at the periphery of the scar of a healed lesion and rarely keloidal and verrucous forms have been described over the lower limbs.[2] A verrucous type of primary cutaneous leish maniasis lesion has not been commonly described earher.
Weinrauch et al reported that oral ketoconazole in doses of 200-400 mg/day yielded a 70% cure rate.[4] This patient was put on 400 mg of ketoconazole per day for eight weeks, by which time almost complete resolution was seen without any side effects of the drug. 

   References Top

1.Amy Beth Koff AB, Rosen T. Treatment of cutaneous Leishmaniasis. J Am Acad Dermatol 1994; 31: 693-710.  Back to cited text no. 1    
2.Harman RRM. Parasitic worms and protozoa. In: Rook A, Ebling FJG, Wilkinson DS, et al, eds. Textbook of Dermatology. Blackwell Scientific Publication 1986;1020-1024.  Back to cited text no. 2    
3.Petit JHS. Keloidal and verrucous Leishmaniasis. Br J Dermatol 1962; 74: 515.  Back to cited text no. 3    
4.Weinrauch L, Liushin R, El-On J. Ketconazole in cutaneous Leishmaniasis. Br J Dermatol 1987;117:666-667.  Back to cited text no. 4    


Print this article  Email this article
Previous article Next article


Online since 15th March '04
Published by Wolters Kluwer - Medknow