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Leishmaniasis of the lip diagnosed by lymph node aspiration and treated with a combination of oral ketaconazole and intralesional sodium stibogluconate.

Vasudevan B, Bahal A - Indian J Dermatol (2011)

Bottom Line: Skin smear and biopsy from the lesion did not yield the diagnosis.Needle aspiration from the draining lymph node revealed the diagnostic Leishman-Donovan bodies.The patient responded to treatment with a combination of oral ketoconazole and intralesional sodium stibogluconate.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, MH Shillong, Meghalaya- 793001, India.

ABSTRACT
A 26-year-old male who presented to the dermatology OPD with complaints of a swelling on his lip of 6 months' duration was on examination found to have a solitary ulcerated nodule over the lip and an enlarged submental lymph node. Skin smear and biopsy from the lesion did not yield the diagnosis. Needle aspiration from the draining lymph node revealed the diagnostic Leishman-Donovan bodies. The patient responded to treatment with a combination of oral ketoconazole and intralesional sodium stibogluconate. We report this case because of both the unusual location of the lesion and the unusual method of diagnosis and treatment.

No MeSH data available.


Related in: MedlinePlus

FNAC from submental lymph node demonstrating classical LD bodies
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Figure 3: FNAC from submental lymph node demonstrating classical LD bodies

Mentions: Investigations revealed a total leukocyte count of 7800/mm3and absolute eosinophilic count of 1050/mm.[1] All other hematological, biochemical, and radiological investigations were normal. VDRL and ELISA for HIV were negative. Slit-skin smear from the lesion showed lymphocytes with plasma cells, but no diagnostic clue was obtained. Skin biopsy from the edge of the lesion showed well-defined lymphocyte granulomas, with few plasma cells [Figure 2]; however no definite diagnosis could be made. As we were not able to confirm the diagnosis with these usual tests, we carried out fine needle aspiration cytology (FNAC) from the draining lymph node. Slides from the aspirate showed macrophages filled with Leishman-Donovan (LD) bodies [Figure 3]. A few LD bodies were seen outside the cells also. The diagnosis of cutaneous leishmaniasis was thus confirmed.


Leishmaniasis of the lip diagnosed by lymph node aspiration and treated with a combination of oral ketaconazole and intralesional sodium stibogluconate.

Vasudevan B, Bahal A - Indian J Dermatol (2011)

FNAC from submental lymph node demonstrating classical LD bodies
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3108527&req=5

Figure 3: FNAC from submental lymph node demonstrating classical LD bodies
Mentions: Investigations revealed a total leukocyte count of 7800/mm3and absolute eosinophilic count of 1050/mm.[1] All other hematological, biochemical, and radiological investigations were normal. VDRL and ELISA for HIV were negative. Slit-skin smear from the lesion showed lymphocytes with plasma cells, but no diagnostic clue was obtained. Skin biopsy from the edge of the lesion showed well-defined lymphocyte granulomas, with few plasma cells [Figure 2]; however no definite diagnosis could be made. As we were not able to confirm the diagnosis with these usual tests, we carried out fine needle aspiration cytology (FNAC) from the draining lymph node. Slides from the aspirate showed macrophages filled with Leishman-Donovan (LD) bodies [Figure 3]. A few LD bodies were seen outside the cells also. The diagnosis of cutaneous leishmaniasis was thus confirmed.

Bottom Line: Skin smear and biopsy from the lesion did not yield the diagnosis.Needle aspiration from the draining lymph node revealed the diagnostic Leishman-Donovan bodies.The patient responded to treatment with a combination of oral ketoconazole and intralesional sodium stibogluconate.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, MH Shillong, Meghalaya- 793001, India.

ABSTRACT
A 26-year-old male who presented to the dermatology OPD with complaints of a swelling on his lip of 6 months' duration was on examination found to have a solitary ulcerated nodule over the lip and an enlarged submental lymph node. Skin smear and biopsy from the lesion did not yield the diagnosis. Needle aspiration from the draining lymph node revealed the diagnostic Leishman-Donovan bodies. The patient responded to treatment with a combination of oral ketoconazole and intralesional sodium stibogluconate. We report this case because of both the unusual location of the lesion and the unusual method of diagnosis and treatment.

No MeSH data available.


Related in: MedlinePlus