• rss
  • facebook
  • twitter
  • linkedin

Cutaneous Leishmaniasis

Leishmaniasis is an infection caused by the protozoan parasite belonging to the genus Leishmania. Natural reservoirs are rodents and domesticated dogs, and the vector is the sandfly, a small mosquito-like insect. Ninety percent of all cases of leishmaniasis occur in Saudi Arabia, Iran, Afghanistan, Brazil, and Peru.

The disease begins as a small, red, painless papule, usually 2 to 4 weeks after the sandfly bite. The papule enlarges to approximately 2 cm over the next 2 to 4 weeks and becomes dusky red to violaceous in color. The lesion becomes crusted over, and if the crust is removed, a shallow ulcer can be found with a raised, indurated border. Cutaneous leishmaniasis may be associated with small satellite lesions and nodules along the course of the draining lymphatics. After the lesion has been present for 2 months, it ceases expanding and after 3 to 6 months begins to heal, leaving a depressed scar. The number of lesions can range from 1 to 100 or more. Diagnosis depends upon finding the parasites in the skin.

Differential Diagnosis: Cutaneous leishmaniasis can be distinguished from cutaneous anthrax in the following manner.

Cutaneous Leishmaniasis


Cutaneous anthrax

* Patient has traveled to or resides in an endemic area

* Lesions slowly evole from papule to ulcer

*Nodular lymphangitis may be an associated sign

* Eschar is absent


* Ulcer and eschar are surrounded by characteristic non-pitting edema

* Lesion undergoes rapid progression from papule, vesicle, or bulla, to formation edema, necrotic ulcer, and eschar



Search ACP Smart Medicine

Search this point-of-care decision support tool today. A free benefit of ACP membership.

Have questions about the new ABIM MOC Program?

Have questions about the new ABIM MOC Program?

ACP explains the ABIM requirements and offers many free solutions to earn MOC points.

One Click to Confidence - Free to members

One Click to Confidence - Free to members ACP Smart Medicine is a new, online clinical decision support tool specifically for internal medicine. Get rapid point-of-care access to evidence-based clinical recommendations and guidelines. Plus, users can easily earn CME credit. Learn more