Cutaneous leishmaniasis
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Cutaneous leishmaniasis | |
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Synonyms | N/A |
Pronounce | N/A |
Specialty | N/A |
Symptoms | Skin ulcer, skin lesion |
Complications | Secondary infection, scarring |
Onset | Weeks to months after sandfly bite |
Duration | Months to years |
Types | N/A |
Causes | Leishmania parasite |
Risks | Sandfly exposure, immunocompromised state |
Diagnosis | Microscopy, culture, PCR |
Differential diagnosis | Leprosy, cutaneous tuberculosis, fungal infection |
Prevention | Insect repellent, protective clothing, bed nets |
Treatment | Antimonial drugs, amphotericin B, miltefosine |
Medication | N/A |
Prognosis | Generally good with treatment |
Frequency | 0.7 to 1.2 million cases per year worldwide |
Deaths | N/A |
Cutaneous leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania. It is transmitted to humans by the bite of infected female sandflies. The disease presents in the skin and can cause a range of clinical symptoms, from ulcers that fully heal to destructive mucosal disease.
Etiology
Cutaneous leishmaniasis is caused by protozoan parasites from the Leishmania genus. The most common species causing cutaneous leishmaniasis include Leishmania major, Leishmania tropica, and Leishmania aethiopica in the Old World, and Leishmania mexicana, Leishmania amazonensis, and Leishmania braziliensis in the New World.
Transmission
The disease is transmitted by the bite of female sandflies of the genus Phlebotomus in the Old World and Lutzomyia in the New World. The sandflies are tiny, their bite is often painless, and they are most active in twilight, evening, and night hours.
Clinical Presentation
The clinical presentation of cutaneous leishmaniasis can vary greatly. The most common form of the disease causes skin ulcers on the exposed parts of the body, such as the face, arms, and legs. There may also be swollen glands near the site of the initial lesion.
Diagnosis
Diagnosis of cutaneous leishmaniasis is made by identifying the parasite in a smear taken from the ulcer. The parasite can also be grown in culture from the sample. Other diagnostic methods include polymerase chain reaction (PCR) and immunohistochemistry.
Treatment
Treatment of cutaneous leishmaniasis depends on the species of Leishmania causing the infection and the clinical presentation of the disease. Antimonial drugs, such as sodium stibogluconate and meglumine antimoniate, are the most common treatments. Other treatments include amphotericin B, pentamidine, and miltefosine.
Prevention
Prevention of cutaneous leishmaniasis includes control of sandflies and personal protection measures such as using insect repellent, wearing protective clothing, and sleeping under a bednet.
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Contributors: Prab R. Tumpati, MD