“…Specific approaches to treat CL patients have to take in consideration the etiologic agent, patient immune competence, clinical features, and arising complications in the course of Leishmania infection [11, 19]. Atypical infections may require an accurate differential diagnosis with other possible coexisting infections, such as leprosy, tuberculosis, fungal infections, ecthyma, furuncle, carbuncle, North American blastomycosis, paracocciomycosis, yaws, prototheca infection, condyloma acuminate, sporotrichosis, syphilis, lupus vulgaris, cutaneous furuncular myiasis, tungiasis, xanthoma tuberosum, sarcoidosis, pyoderma gangrenosum, and neoplasm [107]. Conventionally, the prompt CL diagnosis is obtained by the identification of amastigotes forms (round intracellular forms with 1.5 μ m to 3 μ m) of Leishmania in biopsy samples of skin lesion (gold standard) by optical microscopic observation [1].…”