Nerve involvement in Indian post kala-azar dermal leishmaniasis.

Sir, Post kala-azar dermal leishmaniasis (PKDL) is a wellrecognized sequel of kala-azar in India, developing in approximately 20% cases after a variable time interval of 1 – 5 years (1). The disease occurs chiefly in the eastern parts of India, an area that also has a high prevalence of leprosy. PKDL manifests as symmetrically distributed hypopigmented macules, papules, infiltrated plaques and nodules, that bear a close resemblance to leprosy, with which it is often confused. Clinical and pathological features to differentiate the two diseases have been described (2). Nerve inflammation on skin biopsy is considered a diagnostic feature of leprosy. We describe a case of Indian PKDL with lesional nerve infiltration, histologically mimicking tuberculoid leprosy. The diagnosis of PKDL was confirmed by serological and gene amplification techniques. Nerve involvement has been reported in the Sudanese variety of PKDL (3). As far as ascertained, this feature has not been previously reported in Indian PKDL.