UNUSUAL CLINICAL VARIANTS OF CUTANEOUS LEISHMANIASIS IN PAKISTAN

Cutaneous leishmaniasis is endemic in the Baluchistan province of Paki stan and poses a great risk to non-immune visitors to the area. The wi de spectrum of clinical variants of this common disease is at times a diagnostic challenge. A total of 1709 patients with cutaneous leishman iasis were recorded over a 1-year period. In 37 (2%) patients the lesi ons were very unusual, and therefore worth reporting. These included a cute paronychial, chancriform, annular, palmoplantar, zosteriform and erysipeloid forms. The zosteriform and erysipeloid forms have rarely b een reported previously but to the best of our knowledge, acute parony chial, chancriform, annular and palmoplantar lesions are being reporte d for the first time. The morphologically unusual lesions may be attri buted to an altered host response or involvement of an atypical strain of parasite in these lesions.