There are three categories of leishmaniasis: cutaneous leishmaniasis, visceral leishmaniasis, and mucocutaneous leishmaniasis.
Approximately 75% of cutaneous leishmaniasis is reported from ten countries in the Middle East, North Africa, and Central and South America [1]. Clinical manifestations range from cutaneous ulcers to systemic multiorgan disease [2]. Localized cutaneous leishmaniasis consists of cutaneous lesions on exposed areas of the skin. The ear is the area most likely to be affected, followed by the nose, upper lip, cheeks, legs, distal upper extremities, and ankles. It begins as a pink-colored papule that enlarges and develops into a nodule or plaque-like lesion (often with central softening), leading to usually painless ulceration with an indurated border. In the photo, we can see the classic Chichlero’s ulcer, an eponym used for localized cutaneous leishmaniasis involving the ear. A diagnosis is made by a biopsy sent for histology, culture, and polymerase chain reaction (PCR) [3].
Take-Home Points
- Leishmaniasis is transmitted by the sand fly (which is endemic in multiple parts of the world, including the Middle East, North Africa, Central and South America).
- The disease has cutaneous, visceral, and mucocutaneous forms.
- Typical therapy involves topical antifungals, though systemic therapy with azoles or amphotericin may be indicated in refractory or complex cases.
