Isolated Leprosy of Bilateral Ear Lobes, A Rare Presentation of Leprosy.

Hansen disease is a chronic infectious disease caused by Mycobacterium leprae. It can present with a variety of clinical manifestations depending on the immune status. Ear lobes are commonly involved in leprosy. However, isolated earlobe involvement of both ear lobes is rare. We present a case of a 25-year-old man who presented with isolated swelling of both pinna, which on slit skin smear turned to be multi-bacillary leprosy. The bilateral pinna swelling started as asymptomatic, multiple skin colored shiny papules which progressively became lobular over a period of a year. Isolated involvement of the pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

Cutaneous Leishmaniasis in Natives of Central Region of Nepal.

We report two cases of cutaneous leishmaniasis in natives of central region of Nepal. The first patient in our series, an adult female, presented with a small nodule on the philtrum of upper lip and the second case, a male child, presented with two crusted plaques on forehead. The final diagnosis was based on histopathological findings; however, species characterization was not possible because of its unavailability in the country. These patients responded well to the treatment with Miltefosine (First case) and Fluconazole (second case). Moreover, these cases sparks a question about the origin of diseases in this region and calls for further research in future to find out the cause and prevalence of this disease in Nepal. This case report also emphasizes to consider cutaneous leishmaniasis as differential diagnosis for granulomatous presentations in our context.