Cutaneous leishmaniasis

Abstract

Cutaneous leishmaniasis is endemic in the tropics and neotropics. It is often referred to as a group of diseases because of the varied spectrum of clinical manifestations, which range from small cutaneous nodules to gross mucosal tissue destruction. Cutaneous leishmaniasis can be caused by several Leishmania spp and is transmitted to human beings and animals by sandflies. Despite its increasing worldwide incidence, but because it is rarely fatal, cutaneous leishmaniasis has become one of the so-called neglected diseases, with little interest by financial donors, public-health authorities, and professionals to implement activities to research, prevent, or control the disease. In endemic countries, diagnosis is often made clinically and, if possible, by microscopic examination of lesion biopsy smears to visually confirm leishmania parasites as the cause. The use of more sophisticated diagnostic techniques that allow for species identification is usually restricted to research or clinical settings in non-endemic countries. The mainstays of cutaneous leishmaniasis treatment are pentavalent antimonials, with new oral and topical treatment alternatives only becoming available within the past few years; a vaccine currently does not exist. Disease prevention and control are difficult because of the complexity of cutaneous leishmaniasis epizoology, and the few options available for effective vector control.

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

“…Disseminated leishmaniasis (DL) ( Figure 1C) is characterized by the presence of multiple (10-300) pleomorphic lesions, mainly acneiform and papular, in two or more noncontiguous areas of the body [17]. In 29% of cases, a mucosal lesion is found.…”

Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

“…In most endemic areas, 1-10 % of localized CL result in ML 1-5 years after localized CL had healed, but reports do exist for which ML presented at the same time with CL [2]. The reason why few patients with CL subsequently develop ML is not known [14].…”

“…Montenegro's test can be helpful; however, it fails to distinguish between past and present infections mainly in endemic areas [2]. Immunohistochemical analysis using Van Damme et al [13].…”

A distinct cutaneous leishmaniasis lesion on the tip of the patient’s nose: A visual warning for European colleagues

“…The leishmania parasites are spread by the bite of infected sandflies. Therefore, the leishmania lesions usually occur on the site of the sandfly bites including face, hands and feet [1]. It has been suggested that approximately 1.71 billion people are at risk for cutaneous leishmaniasis in the world [2].…”

“…The presence of sandflies, climate factors like temperature, unawareness of the disease, poor personal protection, poor housing and environmental conditions are the factors which affect the incidence and distribution of cutaneous leishmaniasis [2]. Cutaneous leishmaniasis occurs worldwide, however, most cases ocur in Afghanistan, Algeria, Brazil, Pakistan, Peru, Saudi Arabia, and Syria [1].…”