Post-kala-azar dermal leishmaniasis associated with AIDS

Abstract

Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

Neutrophils and Macrophages Cooperate in Host Resistance againstLeishmania braziliensisInfection

“…N ew World cutaneous leishmaniasis, caused by Leishmania braziliensis (Lb), 3 is distinguished from other leishmaniasis by its chronicity, latency, and tendency to metastasize in the human host (1). During infection with Lb, development of clinical lesions coincides with an influx of inflammatory cells such as macrophages, eosinophils, and neutrophils (2,3).…”

Nested PCR Assay for Detection of Leishmania donovani in Slit Aspirates from Post-Kala-Azar Dermal Leishmaniasis Lesions

“…The nested PCR assay used in the present study circumvented such limitations and showed a high degree of sensitivity even in macular cases. Cases of PKDL infection in patients with human immunodeficiency virus (HIV) have been reported (1,7). Since the incidence of HIV infection is on the increase in India, HIV patients coinfected with Leishmania are likely to present in the future.…”

Disseminated Cutaneous Leishmaniasis Resembling Post-Kala-Azar Dermal Leishmaniasis Caused by Leishmania donovani in Three Patients Co-Infected with Visceral Leishmaniasis and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Ethiopia

“…29 PKDL is thought to be uncommon in HIV/AIDS patients and so far only a few cases of PKDL in HIV-positive patients have been reported from other foci. 4,[40][41][42] However, in Ethiopia, PKDL is reported to be more common in HIV-positive patients than in HIV-negative VL patients. 43 This finding is controversial but severity of immunosuppression in these patients is unknown because CD4 cell counts were not reported.…”