Postkala-azar dermal leishmaniasis coexisting with borderline tuberculoid leprosy

This is the authors' abstract. We don't add key points for this paper.

Conflicts of interest: none declared. Sir, Postkala‐azar dermal leishmaniasis (PKDL) is a dermatosis described during the first quarter of the last century. It is a dermal manifestation in patients with treated kala‐azar, is caused by the protozoan parasite Leishmania donovani and is almost completely confined to the Indian subcontinent, particularly Eastern India, and uncommonly in certain parts of Africa. It is an unusual complication of visceral leishmaniasis (kala‐azar) characterized by erythema and induration particularly involving the butterfly area of the face, presence of hypopigmented macules that are either generalized or localized to the extremities or trunk with sparing of flexures, belt area and the midline areas, and infiltrated papules and nodules typically involving the forehead, chin and muzzle area of the face. While in Indian cases lesions of PKDL usually develop 1–5 years after treatment of kala‐azar, those in Africa may develop during or shortly after treatment. The pathogenesis of PKDL remains obscure. Histopathologically, a polymorphic infiltrate of macrophages, plasma cells and lymphocytes is seen. The detection of Leishman–Donovan (LD) bodies in the macrophages is pathognomonic. Pentavalent antimonials are the treatment of choice.