TRANSACTIONS~F THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE (1992) 86,245-248 245

The clinical features, pathology, immune responses, diagnosis and treatment of post kala-azar dermal eish-maniasis (PKDL) in the Sudan are described and discussed. The disease is characterized by maculopapular or nodular lesions on the face, limbs or trunk. Lesions appear during or within months after the treatment of visceral leishmaniasis, but in 2 of 19 patients there was no previous history of kala-azar. PKDL may be confused with leprosy both clinically and pathologically. Similarities and differences between the 2 diseases are discussed. Unlike visceral eishmaniasis, the peripheral ymphoid cells of patients with PKDL respond to Leishmania antigen and some are leishmanin positive. The response to intravenous odium stibogluconate (20 mg/kg for 30 d) was reasonably good but some patients required repeated or more prolonged treat-ment. Ketoconazole in a dose of 10 mgikg daily for 4 weeks had no effect on PKDL