Skin Disorders
Bookmark and Share
   Acquired Melanocytic Nevocellular Nevi
   Acral Lentiginous Melanoma
   Acute HIV Syndrome
   Acute Lymphangitis
   Acute Sun Damage
   Adult T Cell Leukemia
   Adverse Cutaneous Drug Reactions
   Alopecia Areata
   Androgenetic Alopecia
   Aphthous Ulcer
   Bacillary Angiomatosis
   Bacterial Infections
   Basal Cell Carcinoma
   Basal Cell Nevus Syndrome
   Behcet's Syndrome
   Benign Cutaneous Neoplasms
   Capillary Hemangioma of Infancy
   Cat-Scratch Disease
   Chronic Lupus Panniculitis
   Chronic Venous Insufficiency
   Clark Melanocytic Nevus
   Congenital Nevomelanocytic Nevus
   Crest Syndrome
   Cutaneous Candidiasis
   Cutaneous Larva Migrans
   Cutaneous Lupus Erythematosus
   Cutaneous and Mucocutaneous Leishmaniasis
   Cutaneous Pseudomonas Aeruginosa Infections
   Cutaneous Reactions to Arthropod Bites
   Cutaneous T Cell Lymphoma
   Desmoplastic Melanoma
   Disseminated Coccidioidomycosis
   Disseminated Cryptococcosis
   Disseminated Gonococcal Infection
   Disseminated Intravascular Coagulation
   Drug Hypersensitivity Syndrome
   Drug-Induced Acute Urticaria
   Drug-Induced Pigmentation
   Eosinophilic Folliculitis
   Erysipelas and Cellulitis
   Erythema Infectiosum
   Erythropoietic Protoporphyria
   Exanthematous Drug Reactions
   Exfoliative Erythroderma Syndrome
   Extramammary Paget's Disease
   Eye Stye
   Fixed Drug Eruption
   Gangrenous Cellulitis
   Genital Candidiasis
   Giant Cell Arteritis
   Glucagonoma Syndrome
   Graft Versus Host Disease
   Hand-Foot-and-Mouth Disease
   Herpes Gestationis
   Herpes Simplex Virus: Genital Infections
   Herpes Simplex Virus Infection
   Herpes Simplex Virus: Infections Associated Systemic Immunocompromise
   Herpes Simplex Virus
   Herpes Zoster
   HIV Associated Lipodystrophy Syndrome
   Human Papillomavirus: Mucosal Infections
   Human Papillomavirus: Squamous Cell Carcinoma In Situ
   Human Papillomavirus
   Hypersensitivity Vasculitis
   Hypertrophic Scars and Keloid
   Impetigo and Ecthyma
   Infectious Exanthems
   Infectious Folliculitis
   Infective Endocarditis
   Infestations of the Skin
   Kaposi's Sarcoma
   Kawasaki's Disease

Home :: Cutaneous and Mucocutaneous Leishmaniasis

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.

Causes of Cutaneous and Mucocutaneous Leishmaniasis

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.

Symptoms of Cutaneous and Mucocutaneous Leishmaniasis

  • 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


Clinical suspicion, confirmed by demonstrating amastigotes on smear or in skin biopsy specimen or promastigotes on culture of aspirates or tissue.


Prophylaxis No chemoprophylaxis for travelers exists. OWCL: Delay specific treatment until ulceration occurs, allowing protective immunity to develop, unless lesions are disfiguring, disabling, persist ± 6 months.

Lesional Therapy Local injection of antimonials (Pentostam), usually at weekly intervals; up to 1 mg/kg may be injected in borders of lesions. Also cryosurgery, ultrasound-induced hyperthermia, excision, electrosurgery. Topical 15% paramomycin sulfate, 12% methylbenzethonium chloride in white paraffin twice daily for 10 days.

Systemic Therapy Depends on clinical form. OWCL is usually self-limited and in most cases does not require specific treatment. Treatment should be given for extensive lesions, especially involving face, or for those lesions that invade deeper tissues.

For selected CL, MCL, DCL Sodium antimony gluconate (Pentostam) IV or IM In single daily dose of 10 mg/kg for adults and 20 mg/kg for patients <18 years of age for 10 days. Meglumine antimonate (Glucantime) 20 mg/kg/d for 10 days, ECG control. Amphotericin B, pentamidine, or sodium antimony gluconate plus interferon gamma for resistant cases. Ketoconazole.

Indian VL Milfefosine PO 100 mg qd for 4 weeks.

  • Avoid outdoor activities, especially from dusk to dawn when sandflies are the most active.
  • Infection can be prevented by avoidance of sandfly bites.
  • Wear long-sleeved shirts, long pants, and socks. Tuck shirt into pants.
  • Spray clothing, living and sleeping areas (including bed net) with permethrin-containing insecticides.
  • Apply insect repellent on uncovered skin and under the ends of sleeves and pant legs
More Skin Disorders
   Langerhans Cell Histiocytosis
   Leg Ulcers
   Lentigo Maligna
   Leukemia Cutis
   Livedo Reticularis
   Localized Infection
   Lupus Erythematosus
   Lyme Borreliosis
   Lymphogranuloma Venereum
   Lymphomatoid Papulosis
   Malignant Melanoma of the Mucosa
   Mammary Paget's Disease
   Mastocytosis Syndromes
   Merkel Cell Carcinoma
   Metastatic Cancer to the Skin
   Molluscum Contagiosum
   Mycobacterium Fortuitum Complex Infection
   Mycobacterium Marinum Infection
   Mycobacterium Ulcerans Infection
   Necrobiosis Lipoidica
   Neisseria Gonorrhoeae Infections
   Nodular Melanoma
   Nodular Vasculitis
   Nongenital Herpes Simplex Virus Infection
   North American Blastomycosis
   Oral Hairy Leukoplakia
   Oropharyngeal Candidiasis
   Other Viral Infections
   Papulosquamous Conditions
   Pediculosis Capitis
   Pediculosis Pubis
   Photoallergic Drug Induced Photosensitivity
   Phototoxic Drug Induced Photosensitivity
   Pitted Keratolysis
   Pityriasis Versicolor
   Polyarteritis Nodosa
   Polymorphous Light Eruption
   Porphyria Cutanea Tarda
   Port-Wine Stain
   Premalignant and Malignant Skin Tumors
   Pressure Ulcers
   Pruritic Urticarial Papules
   Pseudoxanthoma Elasticum
   Pyogenic Granuloma
   Radiation Dermatitis
   Raynaud's Disease
   Reiter's Syndrome
   Rocky Mountain Spotted Fevers
   X-Linked Hyper-IgM Syndrome
   Xeroderma Pigmentosum
   Yellow Fever
   Yellow Nail Syndrome
   Zinc Deficiency

Skin Disorders || Contact Us || Tweet

Copyright © All Rights Reserved.

Disclaimer - The data contained in the Web pages is provided for the purpose of educational purposes and information only. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. We are not responsible for any consequence resulted from using this information. Please always consult your physician for medical advices and treatment.