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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 5

Periocular cutaneous leishmaniasis


1 Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, (A Unit of Medical Research Foundation, Chennai), Kolkata, West Bengal, India
2 Department of Pathology, Medica Super Specialty Hospital, Kolkata, West Bengal, India

Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Md Shahid Alam
Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Mukundapur, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1766_20

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How to cite this article:
Alam MS, Chatterjee S. Periocular cutaneous leishmaniasis. Indian J Ophthalmol Case Rep 2021;1:5

How to cite this URL:
Alam MS, Chatterjee S. Periocular cutaneous leishmaniasis. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Feb 26];1:5. Available from: https://www.ijoreports.in/text.asp?2021/1/1/5/305507



A 45-year-old male from Bhutan presented with complaints of recurrent ulcers around the left periocular region for the past 10 years. The patient had not been able to open his left eye since then. The lesions would resolve partially and would recur again. On examination, the whole of left periocular region was ulcerated with ulcer extending up to the bridge of nose [Figure 1]a. Similar lesions were seen covering the area of the upper lip. The ulcer was covered with black crusts. Both upper and lower eyelids were completely involved and there was complete ankyloblepharon. Computed tomography of the orbit however revealed an intact globe with pre septal soft tissue thickening [Figure 1]b. Biopsy from the lesion showed granulomatous inflammation of the dermis with numerous lymphocytes and histiocytes. The histiocytes showed prominent small oval organisms with bar shaped paranuclear kinetoplast; suggestive of cutaneous leishmaniasis [Figure 1]c. The patient was referred to an infectious disease specialist for management.
Figure 1: (a) External colored photograph showing periocular and upper lip ulcerative skin lesions. (b) Computed Tomography of the orbit showing an intact globe with pre septal soft tissue thickening. (c) Microphotograph (Hematoxylin and Eosin) showing histiocytes with prominent oval organisms and bar-shaped para nuclear kinetoplasts

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Cutaneous leishmaniasis is caused by the bite of phlebotomine sand flies and is endemic in more than 70 countries worldwide.[1] Microscopic examination of the skin lesion and demonstration of the parasite either by Giemsa or Hematoxylin and Eosin stains remains the gold standard for diagnosis. Eyelid cutaneous leishmaniasis generally presents as ulcerative lesion and can masquerade as basal cell carcinoma.[1],[2] The differential diagnosis in many cases include chalazion, dacryocystitis, and eyelid tumors.[2] WHO recommends treating cutaneous leishmaniasis with pentavalent antimonial drugs (Sodium stibogluconate or meglumine antemonate) at 20 mg/kg per day for 20–28 consecutive days.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Oliveira-Neto MP, Martins VJ, Mattos MS, Pirmez C, Brahin LR, Benchimol E. South American cutaneous leishmaniasis of the eyelids: Report of five cases in Rio de Janeiro State, Brazil. Ophthalmology 2000;107:169-72.  Back to cited text no. 1
    
2.
Jaouni T, Deckel Y, Frenkel S, Ilsar M, Pe'er J. Cutaneous leishmaniasis of the eyelid masquerading as basal cell carcinoma. Can J Ophthalmol 2009;44:e47.  Back to cited text no. 2
    


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