Cutaneous Leishmaniasis of Lip and Role of Polymerase Chain Reaction: A Case Report

Abstract

The diagnosis of cutaneous leishmaniasis is mostly confirmed by the identification of parasite
in a skin smear or biopsy. However, this method may not always be sensitive enough to detect
the disease when parasitic load is low. Molecular test such as polymerase chain reactions can
be useful in such circumstances. Here, we report a case of cutaneous leishmaniasis diagnosed
by a polymerase chain reaction test when both smear and biopsy failed to confirm the diagnosis.
A 17-years-old female from mountainous district of Nepal, presented with a crusted plaque
over the upper lip for a duration of 6 months. Both skin smear and biopsy from the lesion
failed to demonstrate Leishmania parasite but a polymerase chain reaction test was positive
for Leishmania donovani. This case emphasizes on the importance of molecular testing such
as polymerase chain reaction when commonly performed diagnostics test fails to support
confirmation of clinical diagnosis.