Leishmaniasis of the nose caused by different species of Leishmania in the Sudan. Distinguishing features of the different clinical forms

The nasal mucosa is affected in mucosal leishmaniasis and the skin of the nose, but not the mucosa, may be involved in cutaneous leishmaniasis (oriental sore) and in post kala-azar dermal leishmaniasis (PKDL). These clinical forms all occur in the Sudan and, particularly when advanced, may be confused with each other since mucosal leishmaniasis may extend to the skin of the upper lip and both cutaneous leishmaniasis and PKDL may spread to the anterior nares although they do not extend into the mucosa. Illustrative examples of the three conditions are described. Distinctive features of each form are given. The importance of making the correct diagnosis is stressed, since the different forms respond differently to anti-leishmanial drugs.