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Cutaneous Leishmaniasis in High-Altitude: A Case Report From Nepal.

Eliz Aryal¹, Rohan Sapkota¹, Sunny Shrestha¹

¹Department of Dermatology Kathmandu Medical College and Teaching Hospital, Sinamangal Kathmandu Nepal.

Clinical Case Reports

|April 22, 2026

Summary

Cutaneous leishmaniasis, a parasitic infection, can present with papulo-nodular lesions. This case report emphasizes considering this diagnosis in non-endemic regions like Nepal.

Keywords:

Nepal Phlebotomus altitude cutaneous leishmaniasis skin

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Area of Science:

Medical Parasitology
Dermatology
Infectious Diseases

Background:

Leishmaniasis is a parasitic disease transmitted by sandflies, with cutaneous leishmaniasis being the most prevalent form.
While visceral leishmaniasis is common in Nepal, cutaneous leishmaniasis is rarely reported, primarily in migrant populations.
Papulo-nodular lesions with central necrosis are characteristic of cutaneous leishmaniasis.

Purpose of the Study:

To report a case of cutaneous leishmaniasis in a non-endemic area of Nepal.
To highlight the diagnostic considerations for papulo-nodular lesions in regions where leishmaniasis is not typically found.

Main Methods:

A case study of a 30-year-old female presenting with multiple nodules on her face.
Diagnostic confirmation through punch biopsy of the lesion, identifying amastigote forms of Donovan bodies.
Treatment administered: Oral Miltefosine for 4 weeks.

Main Results:

The patient presented with multiple non-tender nodules, approximately 3x4 cm and 5x4 cm, on her left lower chin and right lower eyelid, respectively.
Punch biopsy confirmed the presence of amastigote forms of Donovan bodies, indicative of cutaneous leishmaniasis.
The patient responded to a 4-week course of oral Miltefosine.

Conclusions:

Cutaneous leishmaniasis should be considered in the differential diagnosis of papulo-nodular lesions, even in non-endemic areas like Nepal.
Early diagnosis and treatment are crucial for managing cutaneous leishmaniasis effectively.
This case underscores the importance of clinical vigilance for parasitic infections in diverse geographical settings.