Wide-spread cutaneous leishmaniasis in a patient with reactional leprosy

A 70-year-old farmer from North Central Province presented in August 2001 with widespread multiple ulcerative plaques of 2 years duration. He has been on treatment for clinico-pathologically proven reactional Leprosy at Anuradhapura without a significant improvement.

Smears from several lesions, including lesion over the nose, were positive for Leishmania amastigotes. Histology of the nasal lesion demonstrated a dense lymphocyte infiltrate with granulomatous reaction.

Coexisting cutaneous leishmaniasis and leprosy has been reported before in the world literature. However, this is the first case of coexisting cutaneous leishmaniasis and leprosy reported in Sri Lanka, and the first patient to be treated successfully with systemic Sodium Stibogluconate therapy.