Mystery diagnosis

The answer is cutaneous leishmaniasis.⠀⠀⠀⠀⠀⠀⠀⠀⠀

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Leishmaniasis is a disease caused by an intracellular protozoan parasite, transmitted by the bite of a female phlebotomine sandfly. ⠀⠀⠀⠀⠀⠀⠀⠀⠀

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There are three primary clinical forms: Cutaneous leishmaniasis, mucocutaneous leishmaniasis, and visceral (kala-azar, Dumdum fever) leishmaniasis.⠀⠀⠀⠀⠀⠀⠀⠀⠀

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Cutaneous leishmaniasis (also known as oriental or tropical sore) usually produces ulcers on the exposed parts of the body, such as the face, arms, and legs. When the ulcers heal, they leave permanent scars, which are often the cause of severe social prejudice.⠀⠀⠀⠀⠀⠀⠀⠀⠀

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Mucosal leishmaniasis affects nasopharyngeal tissues and can cause gross mutilation of the nose and palate. Visceral leishmaniasis causes irregular fever, hepatosplenomegaly, pancytopenia, and polyclonal hypergammaglobulinemia with high mortality in untreated patients. ⠀⠀⠀⠀⠀⠀⠀⠀⠀

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Diagnosis of leishmaniasis is made by demonstrating parasites in Giemsa-stained smears or cultures.⠀⠀⠀⠀⠀⠀⠀⠀⠀

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Treatment options for cutaneous leishmaniasis depending on the lesion and organism include: sodium stibogluconate, miltefosine, and liposomal amphotericin B. 

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