Lupoid Cutaneous Leishmaniasis: A Case Report

Background: Lupoid Cutaneous Leishmaniasis(LCL) is rare type of cutaneous leishmaniasis that clinically and histologically mimics other granulomatous skin conditions like Lupus Vulgaris. This similarity often cause difficulty in diagnosis, especially in endemic areas. Case Presentation: We report a case of a 29-year-old male who presented with isolated plaque on right cheek persisting for 2 years. The lesion was slowly progressive, non-tender and had not responded completely to local therapy. Smear of initial lesion revealed +LD bodies but the recurrent lesion showed no amastigotes on smear. Histopathology report demonstrated tuberculoid granuloma.These findings gave us diagnostic challenge between leishmaniasis and other granulomatous disorders. Based on history, clinical examination and histopathology report our diagnosis was lupoid leishmaniasis. We gave Intramuscular injection of 20mg/kg Meglumine Antimonate (MA) OD for one month. After one month of follow up, we gave Intralesional MA 1-3ml at the base of the lesion 14 times and this resulted in complete cure of patient. Discussion: This case emphasizes the need of including LCL in the differential diagnosis of chronic granulomatous facial lesions, particularly when there is a history of travel to an endemic location. Early detection and precise diagnosis are critical for avoiding misdiagnosis and unneeded anti-tuberculous treatment.