Authors:
Dr. Prajwal Pudasaini, Dr. Prashanta Pudasaini
Department of Dermatology Gandaki Medical College Teaching Hospital
(GMCTH), Pokhara, Nepal. Email:
prajwalpudasaini@gmail.com
Phone no: +9779849447266
Conflict of interest : None
Key clinical message: Cutaneous Leishmaniasis (CL) is the most
prevalent clinical form of leishmaniasis and is caused by vector borne
protozoan parasite. Variation in diagnostic accuracy exists. A
54-year-old female farmer by occupation presented with lesion over right
thigh for 8 months.
Lesion evolved over period of 2-3 months and progressed to form ulcer
with surrounding redness. On examination, solitary plaque with
crateriform ulcer 3*2 cm in size roughly oval in shape was present.
Ulcer floor was moist, smooth shiny with serous discharge and well
defined raised erythematous margin was present. Biopsy was done which
showed features suggestive of lupus vulgaris, for which Anti Tubercular
Treatment (ATT) was started. There was persistence of ulcer despite 4
months of ATT, for which diagnosis was reconsidered and Fine Needle
Aspiration Cytology (FNAC) was performed. FNAC showed numerous intra and
extracellular amastigotes suggestive of Leishmaniasis which was treated
with complete disappearance of ulcer over 4 months.