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| OPHTHALMIC IMAGE |
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| Year : 2021 | Volume
: 1
| Issue : 1 | Page : 5 |
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Periocular cutaneous leishmaniasis
Md Shahid Alam1, Sanhita Chatterjee2
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 Publication | 31-Dec-2020 |
Correspondence Address:
Dr. Md Shahid Alam
Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Mukundapur, Kolkata, West Bengal
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijo.IJO_1766_20
How to cite this article:
Alam MS, Chatterjee S. Periocular cutaneous leishmaniasis. Indian J Ophthalmol Case Rep 2021;1:5 |
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 | |  |
| 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.  |
| 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. |
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