Post-Kala-Azar dermal leishmaniasis in Mymensingh, Bangladesh.

摘要: A 50-year-old man from Mymensingh district, Bangladesh, presented with a 3-month history of non-pruritic, painless hypopigmented papules, and plaques, beginning on the face subsequently spreading to forearms, torso, legs (Figures 1–4) Fifteen months before onset skin lesions, patient had visceral leishmaniasis (kala-azar), successfully treated 30 intramuscular injections sodium stibogluconate (SSG). Polymerase chain reaction showed Leishmania donovani DNA in buffy coat specimen. Figure 1. The has papules plaques scattered over face, most concentrated peri-orally cheeks, common areas involvement for post-kala-azar dermal (PKDL). The consented having his picture published ... Figure 4. The both forearms. absence sensorineural changes helps distinguish (PKDL) leprosy, which commonly presents macules or patches associated 2. Hypopigmented are seen patient's back. lesions roughly symmetrical, characteristic (PKDL), non- pruritic. Figure 3. Hypopigmented abdomen. Post-kala-azar is chronic rash usually apparently cured kala-azar patients East Africa South Asia. In Indian subcontinent, cumulative PKDL incidence after 5–10%.1 erythematous macules, sometimes progressing nodules. Kala-azar antimonial drugs may have poorer immune recovery higher risk subsequent compared those amphotericin formulations.2 only treatment regimens proven efficacy Asia consist 120 SSG 6 miltefosine 2.5 mg/kg/day 12 weeks. infectious sand fly vector thought represent an important parasite reservoir anthroponotic transmission cycle Asia.1