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PKDL After VL — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsPKDL After VLSCE Infectious Diseases

A 40-year-old man from endemic area presents with visceral leishmaniasis (kala-azar). He is treated with Liposomal Amphotericin B and recovers. One year later, he develops multiple hypopigmented macules and papules across his face and trunk. Leishmania amastigotes are present on skin biopsy. What is this condition?

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Correct answer: E — Post-kala-azar dermal leishmaniasis (PKDL) — a dermatological sequel of visceral leishmaniasis occurring weeks to years after VL treatment; the patient serves as a reservoir for Leishmania transmission

PKDL occurs in 5–10% of patients after VL treatment in East Africa (within 6 months) and up to 20% in the Indian subcontinent (sometimes years later). The hypopigmented/papular/nodular skin lesions contain Leishmania amastigotes and serve as a reservoir for transmission to sandflies — making PKDL a public health concern. Treatment depends on severity and region: mild cases may self-resolve; moderate-severe requires prolonged Liposomal Amphotericin B, Miltefosine, or Sodium Stibogluconate. PKDL is a major barrier to VL elimination programmes.

Reference: WHO 2022 – Leishmaniasis; NICE CKS 2024 – Leishmaniasis