Divya Chandramohan

From @jama.com: HHS Secretary Robert F Kennedy Jr's sudden removal of #COVID19 vaccine recommendations for healthy children and pregnant women risks diminishing trust and access to vaccines.

ja.ma/4kXCOPU #MedSky

Rx- topical paramomycin, intralesional pentamidine/ ampho. Cryo or thermo therapy are options. Ampho has the best efficacy against all cutaneous leish. Azoles or miltefosine an option. Ketoconazole systemic -significant hepatoxicity risk. Fluc only works against some strains.

Dx- biopsy, leishmania amastigote identification with kinetoplast. Sometimes gram stain picks up kinetoplast and parasites are seen within macrophages. PCR of lesion is an option.

Evolution is papules -> plaques -> ulcers. Could have satellite lesions, adenopathy, nodular lymphangitis (sporotrichoid-like). Prevention with protective clothing and insect repellant to percent sandfly bites (seen in sandy/ marshy areas and most active in dusk & dawn).

Cutaneous Leishmaniasis | NEJM A 25-year-old man presented to our clinic with a 1-year history of skin lesions on his nose and arm. Physical examination was notable for painless erythematous papules and nodules with overlying sc...

Cutaneous leishmananiasis is an important differential for this condition. This NEJM article depicts a gentleman from Iran, an endemic site for cutaneous leish. Timeline months -yrs. Could evolve rapidly after immunosuppression, trauma.

www.nejm.org/doi/abs/10.1...

"An old man and his grandson " by Dominico Ghirlandaio, C 1490, currently in Louvre.

Subject of the painting is an unknown figure. Prominent feature is rhinophyma (nose deformity) depicted. This occurs with untreated rosacea, indicating the model for the painting likely had rosacea.

Excited to share that our article is amongst the most-cited recent articles in Journal of Antimicrobial Chemotherapy! @mdanderson.bsky.social

academic.oup.com/jac/article/...

#Fusariosis @msgerc.bsky.social