User:Mr. Ibrahem/Post-kala-azar dermal leishmaniasis

Post-kala-azar dermal leishmaniasis (PKDL) is a complication following visceral leishmaniasis (VL) characterized by white areas of skin. There may also be smaller or larger bumps. The rash usually begins around the mouth and spreads to the face and upper trunk. There are generally few other symptoms.

Onset in India is generally within months to years of treatment of VL, while onset is more rapid in Africa. In India, cases may also occur in those who have not been diagnosed with VL and these people are infectious for the Leishmania donovani parasite, thus potentially perpetuating the disease. Diagnosis is usually based on symptoms. The underlying mechanism is believed to involve an immune reaction.

Treatment is often with miltefosine, sodium stibogluconate or amphotericin B; though in Sudan it may resolve on their own. These medications are taken for months. Following treatment a long time is required for the skin to return to normal.

PKDL mainly occurs in Sudan and India, areas affected by Leishmania donovani. It occurs in between 2.5 and 20% of people who have had VL. Adults and children are affected with similar frequency. It was first described in 1922 by Sir Upendranath Brahmachari, who called it dermal leishmanoid.