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Dermatology Image Challenge Infectious disease The appearance of this Tunisian woman's ear is most consistent with which one of the following infectious diseases?

The appearance of this Tunisian woman's ear is most consistent with which one of the following infectious diseases?


image
Question
The appearance of this Tunisian woman's ear is most consistent with which one of the following infectious diseases?
Leprosy
Leishmaniasis
Syphilis
Tuberculosis
Yaws

 

 


Correct Answer : Leishmaniasis

Explanation :

Cutaneous leishmaniasis is endemic in Tunisia, particularly in the central and northern parts of the country. Lupoid leishmaniasis is an uncommon form of chronic cutaneous leishmaniasis associated with Leishmania tropica. A polymerase-chain-reaction assay performed on a biopsy specimen from this patient was positive for leishmania

Promastigotes in the sandfly change into amastigotes upon inoculation into a host. Macrophages phagocytose the amastigotes. The leishmania replicate within the macrophages, resulting in granuloma formation.

Activated T-cells are present, resulting in a positive leishmanin test, but despite this parasite replication continues.

Typically the infection is cleared after months of inflammation.


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