• Niraj Parajuli, Krishna Das Manandhar, Srijan Shrestha, and Anup Bastola.
• Department of Dermatology and Venereology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2020 Jul 31; 58 (227): 494-496.

AbstractThe diagnosis of cutaneous leishmaniasis is mostly confirmed by the identification of parasite in a skin smear or biopsy. However, this method may not always be sensitive enough to detect the disease when parasitic load is low. Molecular test such as polymerase chain reactions can be useful in such circumstances. Here, we report a case of cutaneous leishmaniasis diagnosed by a polymerase chain reaction test when both smear and biopsy failed to confirm the diagnosis. A 17-years-old female from mountainous district of Nepal, presented with a crusted plaque over the upper lip for a duration of 6 months. Both skin smear and biopsy from the lesion failed to demonstrate Leishmania parasite but a polymerase chain reaction test was positive for Leishmania donovani. This case emphasizes on the importance of molecular testing such as polymerase chain reaction when commonly performed diagnostics test fails to support confirmation of clinical diagnosis.

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