Skin Deep

A 15 year old girl of Peruvian origin presents with a 3 month history of a slowly enlarging erythematous plaque extending over her nose and left cheek.

The lesion started as a small, asymptomatic papule which slowly increased in size.

Her medical and surgical histories are unremarkable; her family history is significant for Discoid Lupus Erythematosus in her mother.

She spent her summer vacation with her grandmother in Peru and returned home 1 month prior to the onset of symptoms.

Select Relevant Investigations
Full Blood Count

Performed

WBC: 9600/mm3 (4000-11000)
N: 55% (50-70)
L: 35% (20-40)
Hb: 13.2 g/dL (11.5-15.5)
Platelets: 220,000 (150,000-400,000)
Skin Scrapings for Leishmania

Performed

The skin scrapings are negative for Leishmania amastigotes.
Biopsy of Skin Lesion

Performed

There is a diffuse dermal infiltrate predominantly consisting of macrophages. Numerous intracellular amastigotes are present.
Antinuclear Antibodies

Performed

Negative

Select Relevant Management
Meglumine Antimonate
Amphotericin B
Avoid Exposure to Sun
Corticosteroids