Extensive Post-Kala-Azar Dermal Leishmaniasis.

A 16-year-old male from Bihar had confluent hypopigmented plaques along with erythematous succulent papules on the chin, trunk, and shoulders for the past 8 years. There was relative sparing of axillae, suprapubic, and inguinal regions [Figures 1a–c]. He had a history of kala-azar. Skin biopsy and smear showed numerous Leishman Donovan bodies [Figure 1d]. rk39 antigen detection was positive.[12] Human immunodeficiency virus serology was nonreactive, and CD4 and CD8 counts were normal. He had extensive post-kala-azar dermal leishmaniasis along with tuberculous lymphadenitis and pleural effusion. He improved with a combination therapy of sodium stibogluconate 10 mg/kg and rifampicin 15 mg/kg along with antitubercular treatment.[3]

Figure 1

(a-c) Extensive hypopigmented and infiltrated skin along with juicy papules on the chin, trunk, and shoulder. (d) Amastigote forms of Leishmania donovani (LD) in the histiocytes (Giemsa, ×400)

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