26 yr old man from Bihar comes with juicy looking papules over face and back of neck which were hypopigmented and normoaesthetic with no nerve thickening. History of prolonged fever in childhood was present. Diagnosis: (A) Tuberculoid leprosy, (B) Post Kala Azar dermal leishmaniasis, (C) Lepromatous leprosy, (D) Lupus vulgaris
Answer is B. The diagnosis is post kala Azar dermal lieshmansiasis: Post-kala-azar dermal leishmaniasis (PKDL) is a complication of visceral leishmaniasis (VL); it is characterised by a macular, maculopapular, and nodular rash in a patient who has recovered from VL and who is otherwise well. Ref Harrison 20th edition pg 1234