Skin Diseases

Skin Diseases

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Cutaneous and Mucocutaneous Leishmaniasis

Leishmaniasis is a parasitic infection caused by many species of the protozoa Leishmania, manifested clinically as four major syndromes-cutaneous leishmaniasis (CL) of Old and New World types, mucocutaneous leishmaniasis (MCL), diffuse cutaneous leishmaniasis (DCL), and visceral leishmaniasis (VL). CL is characterized by development of single or multiple cutaneous papules at the site of a sandfly bite, often evolving into nodules and ulcers, which heal spontaneously with a depressed scar.


The clinical and immunologic spectrum of leishmaniasis parallels that of leprosy. CL occurs in a host with good protective immunity. MCL occurs in those with an intense inflammatory reaction. DCL occurs with extensive and widespread proliferation of the organism in the skin but without much inflammation or tendency for visceralization. VL occurs in the host with little immune response and/or in immunosuppression. Unlike leprosy, extent and pattern are strongly influenced by the specific species of Leishmania involved. Additional factors that affect the clinical picture: number of parasites inoculated, site of inoculation, nutritional status of host, nature of the last non-blood meal of vector. Infection and recovery are followed by lifelong immunity to reinfection by the same species of Leishmania. In some cases, interspecies immunity occurs.


* Skin ulcer, forms at site of original lesion
* Smaller lesions may form around the ulcer (satellite lesions)
* Macule or papule, erythematous
* Ulcer heals very slowly over a matter of months

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