Divya Chandramohan
@dr-sketchartist.bsky.social
Infectious Disease doctor at UT Health SA, and artist. Pronouns: she/her. Thoughts are my own. Posts are art-based learning.
Rx- topical paramomycin, intralesional pentamidine/ ampho. Cryo or thermo therapy are options. Ampho has the best efficacy against all cutaneous leish. Azoles or miltefosine an option. Ketoconazole systemic -significant hepatoxicity risk. Fluc only works against some strains.
June 14, 2025 at 4:11 AM
Rx- topical paramomycin, intralesional pentamidine/ ampho. Cryo or thermo therapy are options. Ampho has the best efficacy against all cutaneous leish. Azoles or miltefosine an option. Ketoconazole systemic -significant hepatoxicity risk. Fluc only works against some strains.
Dx- biopsy, leishmania amastigote identification with kinetoplast. Sometimes gram stain picks up kinetoplast and parasites are seen within macrophages. PCR of lesion is an option.
June 14, 2025 at 4:05 AM
Dx- biopsy, leishmania amastigote identification with kinetoplast. Sometimes gram stain picks up kinetoplast and parasites are seen within macrophages. PCR of lesion is an option.
Evolution is papules -> plaques -> ulcers. Could have satellite lesions, adenopathy, nodular lymphangitis (sporotrichoid-like). Prevention with protective clothing and insect repellant to percent sandfly bites (seen in sandy/ marshy areas and most active in dusk & dawn).
June 14, 2025 at 4:01 AM
Evolution is papules -> plaques -> ulcers. Could have satellite lesions, adenopathy, nodular lymphangitis (sporotrichoid-like). Prevention with protective clothing and insect repellant to percent sandfly bites (seen in sandy/ marshy areas and most active in dusk & dawn).
Cutaneous leishmananiasis is an important differential for this condition. This NEJM article depicts a gentleman from Iran, an endemic site for cutaneous leish. Timeline months -yrs. Could evolve rapidly after immunosuppression, trauma.
www.nejm.org/doi/abs/10.1...
www.nejm.org/doi/abs/10.1...
Cutaneous Leishmaniasis | NEJM
A 25-year-old man presented to our clinic with a 1-year history of skin lesions on
his nose and arm. Physical examination was notable for painless erythematous papules
and nodules with overlying sc...
www.nejm.org
June 14, 2025 at 3:52 AM
Cutaneous leishmananiasis is an important differential for this condition. This NEJM article depicts a gentleman from Iran, an endemic site for cutaneous leish. Timeline months -yrs. Could evolve rapidly after immunosuppression, trauma.
www.nejm.org/doi/abs/10.1...
www.nejm.org/doi/abs/10.1...