• Users Online: 217
  • Print this page
  • Email this page


 
  Table of Contents  
THROUGH THE DERMOSCOPE
Year : 2018  |  Volume : 9  |  Issue : 1  |  Page : 78-79  

Dermoscopy of post kala-azar dermal leishmaniasis


1 Department of Skin and V.D, Patna Medical College and Hospital, Patna, Bihar, India
2 SKINNOCENCE: The Skin Clinic, Gurgaon, Haryana, India
3 State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Delfon, Thessaloniki, Greece

Date of Web Publication22-Jan-2018

Correspondence Address:
Abhijeet K Jha
Department of Skin and V.D, Patna Medical College and Hospital, Patna, Bihar
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_49_17

Rights and Permissions

How to cite this article:
Jha AK, Sonthalia S, Lallas A. Dermoscopy of post kala-azar dermal leishmaniasis. Indian Dermatol Online J 2018;9:78-9

How to cite this URL:
Jha AK, Sonthalia S, Lallas A. Dermoscopy of post kala-azar dermal leishmaniasis. Indian Dermatol Online J [serial online] 2018 [cited 2020 Sep 27];9:78-9. Available from: http://www.idoj.in/text.asp?2018/9/1/78/223723



Post Kala-azar dermal leishmaniasis (PKDL) is a late cutaneous manifestation of untreated or partially treated visceral leishmaniasis (VL) and is caused by the same organism, i.e., Leishmania donovani. It characteristically manifests as macules, nodules, plaques, and facial erythema. A 19-year-old male presented with erythematous fleshy papules confined to the chin [Figure 1], along with hypopigmented macules involving the trunk and lower limbs. On evaluation, the patient revealed a history of Kala-azar 1.5 years back with RK-39 test positivity for the patient. Dermoscopy of the erythematous papule from the chin was performed using Dermlite II hybrid m dermatoscope at 10 × magnification in polarized mode and photographs were captured, which revealed multiple yellow tears and erythema [Figure 2]. Histopathology confirmed the diagnosis of PKDL [Figure 3].
Figure 1: Erythematous fleshy papules confined to the chin along with hypopigmented macules involving the trunk

Click here to view
Figure 2: Dermoscopy of the erythematous papule from the chin revealed erythema, multiple yellow tears with few yellow clods (Polarized, 10×)

Click here to view
Figure 3: Dense infiltrates of plasma cells, histiocytes, and epithelioid cells with occasional round to oval basophilic bodies. (H and E, 10×)

Click here to view


PKDL is a late cutaneous manifestation of VL in untreated or inadequately treated patients. From India, three main presentations have been described, of which one may predominate – erythema and induration on the butterfly area of the face that shows photosensitivity; multiple symmetrical hypopigmented macules that may coalesce; and combinations of papules, nodules, and plaques.[1],[2] Usually, PKDL lesions typically appear around the mouth and spread to other parts of the face; subsequently, spread to upper arms and chest may follow. This pattern is most consistent in papular and nodular PKDL, but to a lesser extent in macular lesions.[3] Skin biopsy from the lesions on the chin (papules) showed dense infiltrate of lymphocytes and epithelioid cells with occasional round to oval bodies in macrophages. Several dermoscopic findings have been described in cutaneous leishmaniasis,[4] the most common ones include erythema, various configurations of vascular structures, white starburst-like patterns, central ulcers, yellow tears, and hyperkeratosis.[5],[6],[7] Because erythema, hyperkeratosis, and hairpin vessels may be observed in many dermatological conditions, they are not considered to be specific for diagnosing cutaneous leishmaniasis.[4] In our patient, yellow tears along with erythema were the main features. Yellow tears correspond to the follicular plugs due to compression stemming from lesional growth and expansion. Thus, dermoscopy can be an auxiliary tool for the diagnosis of PKDL.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Napier LE, Das Gupta CR. A clinical study of post kala azar dermal leishmaniasis. Indian Med Gaz 1930;65:249-57.  Back to cited text no. 1
    
2.
Girgla HS, Marsden RA, Singh GM, Ryan TJ. Post kala azar dermal leishmaniasis. Br J Dermatol 1977;97:307-11.  Back to cited text no. 2
    
3.
Jha AK, Anand V, Mallik SK, Kumar P. Post Kala Azar Dermal Leishmaniasis (PKDL) Presenting with Ulcerated Chronic Paronychia Like Lesion. Kathmandu Univ Med J 2012;10:87-90.  Back to cited text no. 3
    
4.
Taheri AR, Pishgooei N, Maleki M, Goyonlo VM, Kiafar B, Banihashemi M, et al. Dermoscopic features of cutaneous leishmaniasis. Int J Dermatol 2013;52:1361-6.  Back to cited text no. 4
    
5.
Omidian M, Mapar MA. Chronic zosteriform cutaneous leishmaniasis. Indian J Dermatol Venereol Leprol 2006;72:41-2.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Momeni AZ, Aminjavaheri M. Clinical picture of cutaneous leishmaniasis in Isfahan, Iran. Int J Dermatol 1994;33:260-5.  Back to cited text no. 6
    
7.
Yucel A, Gunasti S, Denli Y, Uzun S. Cutaneous leishmaniasis: New dermoscopic findings. Int J Dermatol 2013;52:831-7.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed593    
    Printed3    
    Emailed0    
    PDF Downloaded126    
    Comments [Add]    

Recommend this journal