A 38-year-old man presents with hypopigmented macules and nodules on the face, a destructive nasopharyngeal ulceration with palate perforation, and hoarseness. He is from the Amazon region of Brazil. Leishmania braziliensis is confirmed. This form of leishmaniasis is termed:
- A Post-kala-azar dermal leishmaniasis (PKDL)
- B Diffuse cutaneous leishmaniasis (DCL)
- C Mucocutaneous leishmaniasis (espundia) ✓
- D Leishmania recidivans (lupoid leishmaniasis)
Explanation
Mucocutaneous leishmaniasis (espundia) is caused by Leishmania braziliensis (and L. panamensis) in South America, characterised by destructive mucosal involvement — nasal, oral, and pharyngeal mucosa destruction leading to disfigurement. It appears months-to-years after the primary cutaneous lesion. DCL is caused by L. aethiopica and L. mexicana — widespread non-ulcerating nodules in anergic patients. PKDL occurs after kala-azar (visceral) treatment in Indian/African patients. Lupoid leishmaniasis (L. recidivans) caused by L. tropica shows chronic, slowly progressive, apple-jelly papules at healed scar margins.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.