A 42-year-old Bengali male presents with painless nodules over the face. The face is erythematous, and the surface of some of the large nodules is discolored. He gives history of insect bite in past while he went to the jungle for work. What is the most likely diagnosis?
H/o insect bite followed by the events leading to ulceration in a resident or traveller to an endemic focus strongly suggests cutaneous Leishmaniasis (CL). Post-Kala azar dermal Leishmaniasis: Hypopigmented lesions over trunk & Nodular lesions over face. Lymphocytes are the dominant cells. Demonstration of amastigotes in material obtained from a lesion remains the diagnostic gold standard.
Leprosy
Chronic Fungal infections
Cutaneous Leishmaniasis
Cutaneous tuberculosis
Scabies and other infestations