Diffuse Cutaneous Leishmaniasis in an HIV Sero-Positive Patient - A Diagnostic Dilemma

Cutaneous leishmaniasis is caused by an intracellular protozoan parasite belonging to the genus leishmania and is transmitted by the bite of a female sandfly. Diffuse cutaneous forms of leishmaniasis are rare. We report a case of HIV Sero-positive patient presenting with diffuse skin lesions with initial skin biopsy reported as inadequate and later fine needle aspiration cytology was advised which revealed clusters of macrophages with amastigotes of leishmania and a repeat skin biopsy showed the amastigotes. To conclude, cutaneous leishmaniasis should also be suspected in non-endemic areas, as in our case especially in HIV infected patients and fine needle aspiration should be advised for early diagnosis and treatment. [J Interdiscipl Histopathol 2012; 1(1.000): 45-47