Dhar S, Kaur I, Dawn G, Sehgal S, Kumar B
Department of Dermatology, PGIMER, Chandigarh, India.
Lepr Rev. 1995 Sep;66(3):250-6. doi: 10.5935/0305-7518.19950029.
We report on 4 cases of post-kala-azar dermal leishmaniasis (PKDL). History of kala-azar was available in all 4 patients. Slit-skin smears (SSS) for leishmania donovani (LD) bodies were negative in all 4. In 3 patients hypopigmented lesions were present over the face. Papules and nodules over his lips, tongue, scrotum and dactylitis were some unusual features observed in 1 patient. Histopathological examination showed LD bodies in 2 patients; histopathology was nonspecific in the other 2. All the patients were treated with sodium stibogluconate, 20 mg/kg/day. Infiltrated papules and nodules had subsided by 3 months, while hypopigmented macules took longer to improve. In 3 patients there had previously been a misdiagnosis as leprosy sufferers and they had been treated with antileprosy drugs. Clinical and histopathological differences between PKDL and leprosy are discussed.
我们报告了4例黑热病后皮肤利什曼病（PKDL）。所有4例患者均有黑热病病史。4例患者的利什曼原虫杜氏利什曼虫（LD）体的皮肤涂片检查（SSS）均为阴性。3例患者面部出现色素减退性病变。1例患者出现嘴唇、舌头、阴囊丘疹和结节以及指（趾）炎等一些不寻常特征。组织病理学检查显示2例患者有LD体；另外2例患者的组织病理学检查无特异性。所有患者均接受葡萄糖酸锑钠治疗，剂量为20mg/kg/天。浸润性丘疹和结节在3个月时消退，而色素减退性斑改善所需时间更长。3例患者之前被误诊为麻风病患者，并接受了抗麻风病药物治疗。文中讨论了PKDL和麻风病在临床和组织病理学上的差异。
