Leishmaniasis is one of the most neglected tropical diseases. Almost 90% of mucocutaneous leishmaniasis (MCL) has been reported from South America. Reports of MCL are rare in the Indian subcontinent and only few have demonstrated the causative organism. A retrospective study was done including all suspected cutaneous leishmaniasis (CL) and MCL cases detected to be positive for Leishmania spp. by PCR for a 10 year period from January 2008 to December 2018. Clinical details, histopathology, tissue culture in Novy-MacNeal-Nicolle media, anti-rK39 antibody dipstick and tissue PCR followed by RFLP or sequencing using LD1 and ITS primers was done. Of the 63 patients suspected to have cutaneous or MCL, 11patients were confirmed to have leishmaniasis. Culture was positive in 6 of these patients. All showed granulomatous inflammation and five showed Leishmania Donovan bodies. Of the 11 patients six were MCL, three were CL and two had post kala azar dermal leishmaniasis (PKDL). All patients were male, age ranged from 13 to 76years; duration of the lesions ranged from 4months to 12years. Patients with MCL, presented with plaques or nodules or ulceroproliferative lesions; longest duration being 10 years. None had history of travel to areas endemic for MCL. All were caused by L.Donovani. The three patients with CL, presented with multiple nodules and plaques, one of whom had concomitant visceral leishamniasis; longest duration at presentation was one year. Two were caused by L. Major and one by L.Donovani. Two patients with PKDL presented with multiple plaques and patches; longest duration was 12years; both were caused by L.Donovani. All patients except one with PKDL were treated with amphotercin B. Hitherto uncommon MCL, caused by L.Donovani, emerged as a new manifestation of leishmaniasis in this region. In atypical presentations there was delay in diagnosis and incorrect treatment; hence tissue PCR was helpful in confirming the diagnosis.

Single centre retrospective study of Leishmaniasis with skin manifestations from India