Two years after a facial Oriental sore healed with a scar, a patient develops dull red, scaly, infiltrated papules spreading slowly along the border of the old scar. The lesion persists for years and fails to ulcerate. This presentation represents:

• A Lupus vulgaris
• B Diffuse cutaneous leishmaniasis
• C Post-kala-azar dermal leishmaniasis
• D Leishmaniasis recidivans (lupoid leishmaniasis) ✓

Explanation

Leishmaniasis recidivans is a hypersensitivity relapse at the edge of a healed L. tropica sore, clinically mimicking lupus vulgaris, with a strongly positive leishmanin test and marked resistance to treatment. Diffuse cutaneous leishmaniasis and PKDL occur in anergic states with abundant parasites and negative skin tests, and lupus vulgaris shows caseating granulomas without amastigotes.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.