Open AccessIdentification of atypical dermal leishmaniasis resolved by restriction fragment length polymorphism
Author(s) -
Srija Moulik,
Ritika Sengupta,
Aishwarya Dighal,
Bikash Sardar,
Bibhuti Saha,
Nilay Kanti Das,
Mitali Chatterjee
Publication year - 2020
Publication title -
indian journal of dermatology, venereology, and leprology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.514
H-Index - 45
eISSN - 0973-3922
pISSN - 0378-6323
DOI - 10.4103/ijdvl.ijdvl_14_18
Subject(s) - leishmania donovani , leishmaniasis , visceral leishmaniasis , restriction fragment length polymorphism , polymerase chain reaction , biology , cutaneous leishmaniasis , leishmania , parasite hosting , internal transcribed spacer , virology , immunology , genetics , ribosomal rna , gene , world wide web , computer science
This case report series alerts to the atypical manifestations of dermal leishmaniasis in an area endemic for post kala-azar dermal leishmaniasis, the sequel to visceral leishmaniasis. We have reported two cases with multiple skin lesions, wherein the rK39 strip test, polymerase chain reaction and parasite load confirmed the presence of Leishmania parasites. The causative parasite was identified as Leishmania major by restriction fragment length polymorphism of the ribosomal DNA Internal Transcribed Spacer-1, overruling the clinical suspicion of post kala-azar dermal leishmaniasis. The third case presented with fever and extensive hypopigmented patches in the upper extremities; parasites were identified in blood and skin by polymerase chain reaction and typed by restriction fragment length polymorphism as Leishmania donovani, establishing this as a case of visceral leishmaniasis concomitant with dermal leishmaniasis, secondary to dissemination of viscerotropic L. donovani. The present case series emphasizes the importance of molecular tools to identify the Leishmania species in order to ensure appropriate treatment.