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

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.