Cutaneous Leishmaniasis Presenting As Macrocheilitis In A Post Liver Transplant Pediatric Patient.

A 3-year-old boy, who underwent living donor liver transplantation at 1-year age for biliary atresia presented during his routine follow-up with painful perioral swelling of 2 months’ duration (Fig. 1). He was on a standard tacrolimus-based immunosuppression along with oral prednisolone 1 mg/day. Considering cellulitis, he was treated with intravenous antibiotics for 5 days, but with little improvement. Kaposi sarcoma was considered in immunosuppressed patient and lip biopsy was done, which suggested Leishmaniasis (Fig. 2; arrow showing amastigote). Liposomal Amphotericin 5 mg/kg was given for 7 days. Lesion showed progressive response with complete resolution in a month.