cut leishmanisis(dr samiullah khalil)
DESCRIPTION
dermatology presentation by dr samiullah khalil peshawar pakistanTRANSCRIPT
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Dr Sami Ullah khalilDr Sami Ullah khalil
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Name: XYZName: XYZ Age: 25 YearsAge: 25 Years Gender: MaleGender: Male Rank: SepRank: Sep Deployment: Miran shah Deployment: Miran shah
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Present History
Non healing ulcerated plaque on elbow (Rt)……………………2 months
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IHDIHD DiabetesDiabetes HypertensionHypertension AsthmaAsthma Tuberculosis Tuberculosis
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Pallor: Pallor: NilNil Cyanosis: Cyanosis: Nil Nil Jaundice: Jaundice: NilNil Edema: Edema: NilNil Clubbing: Clubbing: Nil Nil Lymph Nodes: Lymph Nodes: Not palpableNot palpable
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Temp: Temp: 98.4 F98.4 F Pulse: Pulse: 89 /Regular89 /Regular BP: BP: 110/80 mmHg110/80 mmHg Resp: Resp: 16 /Minute16 /Minute
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GIT: GIT: NADNAD
CVS: CVS: NADNAD
CNS: CNS: NADNAD
Respiratory System: Respiratory System: NADNAD
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Smear for LT Bodies ……….. +ve Smear for LT Bodies ……….. +ve
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Patient counseled.
Consent for treatment taken.
Patient started on intralesional meglumine antimoniate twice weekly x 12 weeks.
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CAPT JAMES DONOVAN WILLIAM LEISHMAN
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LeishmaniasisLeishmaniasis
Cutaneous Mucocutaneous Visceral
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Group of diseases caused by infection with Group of diseases caused by infection with one of the protozoan parasites of the genus one of the protozoan parasites of the genus LeishmaniaLeishmania
Designated one of the five most important Designated one of the five most important preventable diseases worldwide by the preventable diseases worldwide by the World Health OrganizationWorld Health Organization
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Affects people in 88 countries of the worldAffects people in 88 countries of the world
Has a global prevalence of 12 million with Has a global prevalence of 12 million with additional 350 million at riskadditional 350 million at risk
Annual incidence of 1.5—2 millionAnnual incidence of 1.5—2 million
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Cut Leishmaniasis is endemic mainly in Cut Leishmaniasis is endemic mainly in Baluchistan, Baluchistan, Interior Sind Interior Sind and and Rural areas of PunjabRural areas of Punjab..
Cut Leishmaniasis due to Cut Leishmaniasis due to L tropica L tropica has the widest has the widest distribution; occurring in urban areas of distribution; occurring in urban areas of Punjab Punjab and and Baluchistan, Northern areas, and Azad KashmirBaluchistan, Northern areas, and Azad Kashmir
Increasingly reported from towns of KPK, FATA Increasingly reported from towns of KPK, FATA and Baluchistanand Baluchistan
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RODENTSRODENTS Tropical & subtropical Tropical & subtropical
china, India, Asia, china, India, Asia, Africa, Mediterranean, Africa, Mediterranean, & Central America & Central America
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DOMESTIC DOGDOMESTIC DOG Mediterranean, Mediterranean,
southern Russia, southern Russia, Afghanistan, India & Afghanistan, India & PakistanPakistan
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VECTOR (Sand Fly)VECTOR (Sand Fly)
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1-HISTORY OF ENDEMIC AREA1-HISTORY OF ENDEMIC AREA
2-MORPHOLOGY OF THE LESION2-MORPHOLOGY OF THE LESION
3- CLINICAL CHARACTERISTICS 3- CLINICAL CHARACTERISTICS
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JlkjkljkJhjkjKl;kl;
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SLIT SKIN SMEARSLIT SKIN SMEAR BIOPSYBIOPSY NNN CULTURENNN CULTURE PCRPCR Kinetoplast minicircle DNAKinetoplast minicircle DNA
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ELISA for circulating antibodiesELISA for circulating antibodies
Leishmanin Skin Test MontenegroLeishmanin Skin Test Montenegro
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Pentavalent AntimonialsPentavalent Antimonials
Na stibogluconate & Meglumine Na stibogluconate & Meglumine
antimoniate antimoniate
1.1. Intra lesionalIntra lesional
2.2. Systemic Systemic
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JlkjkljkJhjkjKl;kl; Jlkjkljk
JhjkjKl;kl;
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FreezingFreezing
Local heatLocal heat
Oral ItraconazolOral Itraconazol
Topical amphotericinTopical amphotericin
Topical aminoglycoside antibioticsTopical aminoglycoside antibiotics
Paromomycin is sometimes effectiveParomomycin is sometimes effective
AllopurinolAllopurinol
Oral MiltefosineOral Miltefosine
Plastic surgeryPlastic surgery
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TimingsTimings dawn and duskdawn and dusk
Full sleevesFull sleeves
Use repellant lotion and repeat after 4 hoursUse repellant lotion and repeat after 4 hours
Use nets if sleeping outdoorsUse nets if sleeping outdoors
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Cutaneous Leishmaniasis has become a Cutaneous Leishmaniasis has become a huge public health problem.huge public health problem.
Cutaneous Leishmaniasis is a Cutaneous Leishmaniasis is a preventable diseasepreventable disease
Med professionals working at various Med professionals working at various levels must be able to recognize and levels must be able to recognize and manage the diseasemanage the disease
Cost-containment in med care demands Cost-containment in med care demands accurate diagnosis made without undue accurate diagnosis made without undue delaydelay
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