The diagnosis and treatment of cutaneous leishmaniasis
Although traditionally mostly confined to the endemic areas of Latin America, Africa, the Middle East and Central Asia, cutaneous leishmaniasis is increasingly seen in clinical practices in the Northern hemisphere due to the consequences of tourism and armed conflict. It is a group of diseases with a varied spectrum of clinical manifestations, ranging from small, benign cutaneous nodules to disfiguring mucosal tissue destruction. Caused by several Leishmania spp., cutaneous leishmaniasis is transmitted to human beings and animals by sandflies. Clinical diagnosis is difficult because diseases of other etiologies with a similar clinical spectrum are common in endemic areas. Hence, any clinical suspicion of cutaneous leishmaniasis should be confirmed by parasitological diagnosis. The standard treatment of cutaneous leishmaniasis is still using pentavalent antimonials. Although effective, antimonials can have potentially severe side effects and, ideally, patients should be monitored closely while undergoing treatment. In recent years, several alternative treatment approaches have become available that could be considered when managing cutaneous leishmaniasis cases.