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Post Kala-azar Dermal Leishmaniasis

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Dr Nilay Kanti Das, Bankura, West Bengal    23 January 2019

  • PKDL serves as reservoir of L. Donovani in the inter-epidemic period of kala-azar; thus elimination of PKDL is necessary to achieve the WHO regional target of elimination of kala-azar by 2020.
  • Increased IL10, IgG1, IgG3, FOXP3; and decreased langerhans cells, CD86, CD28, receptor of INF gamma and TNF alpha are predictors for development of PKDL.
  • Photosensitivity, mucosal and genital involvement, sparing of vaults of axillae and groins are key clinical features helping to differentiate from lepromatous leprosy.
  • rK39 strip test and PCR are important diagnostic aid apart from ELISA and histopathology.
  • Miltefosine and Liposomal Amphotericin B are the effective drugs till date.

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