Cutaneous leishmaniasis

**Definition:** Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethiopia and Asia), where L. major, L. tropica, L. aethiopica and L. donovani infantum predominate. Other sandflies are responsible for transmitting the New World species, L. mexicana and L. brasiliensis. The commonest presentation is with one or more crusted nodules or ulcers on exposed sites which gradually heal with scarring. Mexican and Ethiopian forms have a tendency to cause diffuse infiltration of the skin; South American forms frequently progress to mucocutaneous leishmaniasis.

**Long definition:** Cutaneous leishmaniasis results from bites by sandflies infected by protozoan parasites of the genus Leishmania. Phlebotomus is the principal vector in the Old World (Mediterranean, North Africa, Ethiopia and Asia), where L. major, L. tropica, L. aethiopica and L. donovani infantum predominate. Other sandflies are responsible for transmitting the New World species, L. mexicana and L. brasiliensis. The commonest presentation is with one or more crusted nodules or ulcers on exposed sites which gradually heal with scarring. Mexican and Ethiopian forms have a tendency to cause diffuse infiltration of the skin; South American forms frequently progress to mucocutaneous leishmaniasis (qv).