CASE
Two otherwise healthy Saudi sisters, aged 15 and 13 years, presented with multiple ulcerating skin nodules on the face. The sisters had recently visited a village near Aleppo, Syria, an area known to be endemic for cutaneous leishmaniasis (CL). In both patients, smears from the lesional borders revealed histiocytes filled with microorganisms containing identifiable kinetoplasts. After CL was confirmed, the sisters were treated successfully with a combination of IM sodium stibogluconate (Penostam) and cryotherapy for 10 days.
Eight months later, both girls developed skin-colored papules at the peripheries of their leishmaniasis scars (Figure 1). A punch biopsy confirmed that these papules were caused by leishmaniasis.
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