Skin lesions following visceral leishmaniasis present as -

Ans. is 4b' i.e., Hypopigmented macules Post kala azar dermal leishmaniasis (PKDL)o Late manifestation. Appears 2 years or more after recovery from visceral leishmaniasiso Appear due to inadequate cellular immunity against a dermatophytic variant of L. donavani.o Pin point hypo to de-pigmented macules starting from face then spreading to back, upper limbs and thigho An erythematous bat wing shaped rash on muzzle area of face may be seen, o Later on these macules change into skin colored soft nodules.o Sometimes involves mucous membrane of the tongue, palate and genitalia and also the ears resembling nodular lepromatous leprosy.o Chemotherapy with parental antimonials is the treatment of choice, o Amfotericin B and miltefosine are also effective.