Diagnosis:
Leishmaniasis is a complex disease caused by different species of the genus Leishmania. In many developing countries, the disease constitutes a publich health problem.
Old-world cutaneous leishmaniasis is most frequently caused by L. major, and L. tropica. However, L. donovani, and L. infantum also may invoke the disease. Cutaneous leishmanisis, although annoting to the patient, is not fatal.
Sandflies of genus Lutzomyia in the America, and Phlebatomus elsewhere are vectors for the parasite.
The disease presents in three clinical forms of cuteneous, mucocutaneous and visceral leishmaniasis. A broad spectrum of dermal manifestations ranging from small, dry, crusted
lesions to large, deep, mutilating ulcers may be observed in the cutaneous form of the disease. Cutaneous leishmanisis occurs throughout the tropical and subtropical regions with the highest prevalence in Asia, China, the Mediterranean littoral, India and North Africa. Cutaneous leishmaniasis ussually affects a single area, in our patient, we observed a multiplicity skin leisons. This may be due to either heavy parasite inoculation or her somewhat immune-depression caused by diabetes mellitus.
Direct smear and biopsy of the lesions were diagnostic for cutaneous leishmaniasis. The patient was treated with appropriate regimen and led t healing of the lesion.
F. Zerehsaz,* M.D.,
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*Shiraz Clinic, Saadi Ave, Shiraz, Iran.