Post-kala-azar dermal leishmaniasis (PKDL) is a dermatologic manifestation that usually occurs after visceral
leishmaniasis (VL) caused by
Leishmania donovani
. It is characterized by hypopigmented patches, a
macular or maculopapular rash and nodular skin lesions on the body surface. Involvement of the mucosae
is very rare and unusual in PKDL. We report a case of PKDL that presented with polymorphic skin lesions,
along with involvement of peri-oral mucosa and tongue from an endemic area for kala-azar in Bangladesh.
In the absence of a definite past history of kala-azar, a clinical suspicion for PKDL was confirmed by positive
rapid serological tests against two recombinant (rK39 and rK28) leishmanial antigens, demonstration
of
Leishmania donovani (LD) body in the slit skin smear, and isolation of promastigotes by culture from a
nodular lesion. The patient was treated with oral Miltefosine for three consecutive months and showed
significant clinical improvement as demonstrated by a negative slit skin smear at two months after initiation
of therapy. We report this case as an unusual presentation of mucosal involvement in PKDL and subsequent
treatment success with Miltefosine.
