Leishmaniasis, affecting more than two million individuals every year in various parts of the world, is an infection caused by the protozoan parasite Leishmania [1]. Sand flies are the principal vectors involved in the transmission of this parasite from infected animal hosts to humans, indicating the zoonotic nature of the disease in many parts of the world, including Latin America, countries around the Mediterranean sea, the Middle East, and North Africa [1] [2] [3]. However, a growing number of reports have confirmed a transmission of Leishmaniasis between humans through sand fly vectors in endemic and highly populated areas [4]. More than 20 species have been implicated in the pathogenesis of human infections, while L. tropica is described as one of the main culprits in the development of urban cutaneous leishmaniasis [2]. Regarded as the most common type of Leishmaniasis, the cutaneous presentation is characterized by the appearance of an erythematous papule at the site of the sand fly bite after a period that may last for weeks, months, or even years [2] [3] [4] [5]. The face and the extremities (forearms and lower legs) are the main locations of the initial lesion [3]. The papule progressively increases in size over time and transforms into a nodule that subsequently breaks and forms a raised and well-demarcated ulcer [3] [4] [5]. In most cases, skin lesions resolve spontaneously over time, but their recurrence and dissemination (causing severe cutaneous or mucocutaneous leishmaniasis) can be severely debilitating, particularly when larger lesions affect the face and cause extensive disfiguring [2] [4] [5]. Immunosuppressed patients are at an increased risk for dissemination of the disease [5].

• Fever

  Other terms used to describe visceral disease include Dumdum fever, Assam fever, and infantile splenomegaly in various parts of the world. [emedicine.medscape.com]

  The side-effects of the drug were tenderness (83 per cent), induration (27 per cent) fever (6 per cent) and abscess (2 per cent). No changes in complete blood count were observed. [acta.tums.ac.ir]

  ESSAYS ON THE PUERPERAL FEVER, AND OTHER DISEASES PECULIAR TO "WOMEN. Selected from the writings of British Authors previous to the close of the Eighteenth Century. In one neat octavo volume, extra cloth, of about 450 pages. ‏ [books.google.com]

  The patient develops fever, discomfort from an enlarged spleen, abdominal swelling, weight loss, cough, or diarrhoea. Classically, the fever spikes twice daily, usually without rigors, but daily, irregular, or undulant fevers are common. [enetmd.com]

  […] skin sores (develop w/in weeks or months) -sores can turn into ulcers -change in size/appearance over time Visceral Leishmaniasis symptoms -affects internal organs (spleen, liver, bone marrow) -can be life threatening -develops w/in months or years -fever [quizlet.com]

• Military Personnel

  Click for source Soldiers have also had to contend with other tropical delights such as malaria, Q fever, brucellosis but prevention and control measures have largely kept other infections in check among deployed military personnel (12). [blogs.discovermagazine.com]

  Military Personnel - Southwest/Central Asia, 2002-2003 米軍隊員における皮膚リーシュマニア症－南西/中央アジア,2002～2003年 熱帯、亜熱帯、ヨーロッパ南部へ渡航または居住した軍関係者は、風土病である皮膚リーシュマニア症(CL)感染のリスクを有する。2002－2003年に南西/中央アジアの3ヶ国(アフガニスタン、イラク、クウェート)でCLを発症した米軍隊員22例について予備データを報告する。 [imic.or.jp]

  Cases in US service personnel have reflected military activities (such as in Afghanistan and Iraq). CL is usually more common in rural than urban areas, but it is found in some periurban and urban areas (such as in Kabul, Afghanistan). [wwwnc.cdc.gov]

  The condition is diagnosed every year in travelers, immigrants, and military personnel. Physicians in the United States must be alert to the diagnosis of leishmaniasis in travelers returning from endemic areas. [aafp.org]

  As an imported disease, cutaneous leishmaniasis is common in travellers, military personnel, and immigrants coming from endemic areas, while the diagnosis of the less common visceral leishmaniasis is frequently overlooked. [enetmd.com]

• Malnutrition

  Leishmaniasis in Syria Cutaneous leishmaniasis is often associated with malnutrition, population displacement, poor housing and weakened immune systems, all widespread across Syria. [thementorinitiative.org]

  These include: Poverty Malnutrition Famine Illiteracy Lack of sanitation and proper hygiene Large-scale migration and settlements Leishmaniasis is more common in the villages and small towns (especially in the outskirts) than in the cities Individuals [dovemed.com]

  With prolonged infection, death occurs from respiratory compromise and malnutrition. Mucocutaneous leishmaniasis may arise after inadequate treatment of certain Leishmania species. Children are rarely affected. [emedicine.medscape.com]

  The research found that: -leishmaniasis is highly correlated with poverty, malnutrition and other diseases which affect immunity, as well as factors such as crowded living conditions and poor sanitation. [thenewsminute.com]

  Malnutrition is a risk factors for mucosal leishmaniasis. Infection with L. peruviana occurs in high Andean valleys, where it may be locally common. [enetmd.com]

• Skin Ulcer

  Known locally as uta L. guyanensis The Guyana, Brazil Single skin ulcers, but lymphatic spread may result in widespread ulceration. Known locally as pian bois. [web.stanford.edu]

  The treatment measures include: Oral medicines and topical ointments/applications for skin lesions The skin ulcers may heal without treatment; the administration of appropriate medications can prevent scar formation If the ulcers heal and cause cosmetic [dovemed.com]

  The frequency of old-world cutaneous leishmaniasis in skin ulcers in Peshawar. J Ayub Med Coll Abbottabad 2009;21(3):72-5. 2. Alrajhi AA. Cutaneous Leishmaniasis of the Old World. Skin Therapy Lett 2003;8(2):1-4. 3. [cehjournal.org]

  The cutaneous form of the disease can lead to distressing and disfiguring skin ulcers and scarring, while visceral leishmaniasis, which affects organs such as the liver and spleen, is invariably fatal if not treated. [thenewsminute.com]

  The result of infection can vary from acute or chronic skin ulcer, recurrent or diffuse CL to erosive mucosal disease with progressive destruction of the nasopharynx and severe facial disfigurement, to a life-threatening systemic infection with hepatosplenomegaly [ijmm.org]

• Cutaneous Manifestation

  While in Central America cutaneous manifestations of L. (L) infantum chagasi are quite common, in Brazil they are extremely rare. We report the first case of leishmaniasis with exclusively cutaneous manifestations caused by L. [ncbi.nlm.nih.gov]

• Alopecia

  D Alopecia and lesions on a rock hyrax (Procavia capensis). [jid.oxfordjournals.org]

A comprehensive clinical and microbiological workup is needed in order to recognize leishmaniasis as the underlying cause of skin lesions. A thorough patient history should cover the patient's country of residence and travel to endemic areas, as well as a history of sand fly bites [5]. In the case of urban cutaneous leishmaniasis, physicians must identify the potential source of this parasite in the urban setting, thus patients may be asked whether they have observed similar lesions in other individuals in their environment. A detailed physical examination should follow, during which assessment of skin lesions may point to the diagnosis. To confirm Leishmania as the causative agent, microbiological studies must be employed. Skin lesions can be scraped for microscopic examination (using Giemsa and other staining techniques) or cultivation (up to 10 days are necessary for Leishmania species to grow on specific media), both carrying good diagnostic rates [1] [4] [6]. A skin biopsy and subsequent histological examination have also been recommended [4] [5] [6]. Serological testing should be performed whenever possible, such as the Montenegro's reaction (inoculation of Leishmania antigen) which yields a conclusive result within 72 hours and is particularly useful for establishing an infection in travelers. Polymerase chain reaction (PCR) testing is considered as the most specific and most sensitive [4] [5] [6] [7].

• Leishmania Tropica

  tropica and Leishmania major in urban and rural areas, respectively. [ncbi.nlm.nih.gov]

  Convert to ICD-10-CM : 085.1 converts approximately to: 2015/16 ICD-10-CM B55.1 Cutaneous leishmaniasis Applies To Aleppo boil Baghdad boil Delhi boil Infection by Leishmania tropica (minor) Leishmaniasis, cutaneous: dry form late recurrent ulcerating [icd9data.com]

  Presence, in dogs, of Leishmania infantum Nicolle and Leishmania tropica (Wright) (Kinetoplastida-Trypanonomatidae) [in French], Ann Parasitol Hum Comp, 1991, vol. 66 (pg. 252 - 5 ) 22 Short report: Leishmania tropica : etiologic agent of a case of canine [jid.oxfordjournals.org]

  Distribution of the three old Leishmania parasites [COUGH]. Leishmania major, Leishmania tropica, and Leishmania aethiopica. [COUGH] Excuse me. [coursera.org]

  Leishmania tropica is the most common species in the Bam and Mashhad, respectively (Aflatoonian et al ng1041 ., 2013; Mahmoodi et al ., 2010 ). Sequences alignment showed no differences between isolates and all samples were L. tropica and L. major. [scialert.net]

• Visceromegaly

  An eighty-one-year-old woman presented three pleomorphic skin lesions that were not associated with systemic symptoms or visceromegalies. Multilocus enzyme electrophoresis identified L. [ncbi.nlm.nih.gov]

TREATMENT OF URBAN CUTANEOUS LEISHMANIASIS IN IRAN WITH CYCLOGUANIL PAMOATE. Acta Med Iran. :125-130. [acta.tums.ac.ir]

The vast majority of patients with acute cutaneous leishmaniasis eventually heal without treatment. Recalcitrant or multiple lesions, however may require treatment. Sodium stibogluconate (Pentostam) has been the treatment of choice. [annsaudimed.net]

Treatment Treatment with antimonials will heal lesions faster and prevent relapse, local dissemination, mucosal disease (usually), and transmission. Not all lesions require treatment. [aafp.org]

Treatment Options Treatment options for CL re summarized in Table II. Table II. [dermatologyadvisor.com]

However, a spontaneous resolution of the skin ulcers is also observed in some cases The prognosis depends upon the promptness in providing treatment. [dovemed.com]

Species identification is critical as it determines the clinical course, prognosis and treatment choice, and until the recent development of molecular methods it was only possible through isoenzyme analysis of Leishmania culture. [dermatologyadvisor.com]

Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran. [email protected] Abstract Shiraz district in south of Iran is a classical focus of Cutaneous leishmaniasis (CL) and previous research has consistently documented the etiologic [ncbi.nlm.nih.gov]

(Etiology) Cutaneous Leishmaniasis is an infectious disease caused by the bite of sandflies; small flying insects that are smaller than mosquitoes and less noisy. [dovemed.com]

Etiology Disease expression depends upon a number of factors: Leishmania species, size of Leishmania inoculum, sandfly saliva (has vasodilatory properties) and other vector virulence factors, and host cellular immune responses. [dermatologyadvisor.com]

Presence, in dogs, of Leishmania infantum Nicolle and Leishmania tropica (Wright) (Kinetoplastida-Trypanonomatidae) [in French], Ann Parasitol Hum Comp, 1991, vol. 66 (pg. 252 - 5 ) 22 Short report: Leishmania tropica : etiologic agent of a case of canine [jid.oxfordjournals.org]

Gov't MeSH terms Animals DNA, Kinetoplast/chemistry DNA, Protozoan/chemistry DNA, Ribosomal Spacer/chemistry Female Humans Insect Vectors/classification Insect Vectors/parasitology* Iran/epidemiology Leishmania tropica/classification Leishmania tropica [ncbi.nlm.nih.gov]

[Epidemiologic study of a new foci of anthroponotic cutaneous Leishmaniasis in Isfahan province/Iran]. The 3rd National Epidemiology Congress, Kerman, Iran. 8. [Epidemiologic study of cutaneous Leishmaniasis in Noogh/Rafsanjan in 2005]. [journalssc.com]

Epidemiological Aspects of Cutaneous Leishmaniasis in Iran Salman Khazaei 1, Abdollah Mohammadian Hafshejani 2, Mohammad Saatchi 3, Hamid Salehiniya 3, 4, * and Shahrzad Nematollahi 3 1 Department of Epidemiology and Biostatistics, School of Public Health [archcid.com]

Access the full text: NOT AVAILABLE Lookup the document at: Other subjects epidemiology Leishmania Sex of host Age of host leishmaniasis protozoal infections Vectors, Insecta From the journal Bulletin de la Societe Pathologie Exotique et de ses filiales [agris.fao.org]

University Tropical Parasitology: Protozoans, Worms, Vectors and Human Diseases This course provides students an understanding of important human parasitic diseases, including their life cycles, vectors of transmission, distribution and epidemiology, pathophysiology [coursera.org]

Pathophysiology [ edit ] Promastigotes of Leishmania are transmitted to human skin by the bite of a sandfly. Leishmania then invades human macrophages and replicates intracellularly. [en.wikipedia.org]

[…] venezuelensis CL/MCL OWNW L aethiopicaL braziliensis complexL (Viannia) braziliensisL (Viannia) colombiensisL (Viannia) guyanensisL (Viannia) panamensisL (Viannia) peruviana VL/CL OWNW L donovani complexL donovaniL infantumL donovani complexL chagasi Pathophysiology [dermatologyadvisor.com]

Knowledge of Men and Women about Warning Signs of Cancer and Adoption of Preventive Behaviors. Der Pharmacia Lettre. 2016; 8 (5): 134-40 27. Ghahremani L, Faryabi R, Kaveh M. [emedicalj.com]

How can Cutaneous Leishmaniasis be Prevented? Currently, no vaccination has been discovered to prevent Leishmaniasis. Research is being undertaken to develop a vaccine at the earliest. [dovemed.com]

They prevent affected adults and children from going to school, working, or fully participating in community life, contributing to stigma and the cycle of poverty. [iamat.org]

A partnership in the fight against malaria Relate bracelets partnered with International SOS six years ago; and since then – we have raised more than R600,000 ($43,000) for malaria prevention and social upliftment. [internationalsos.com]

Exciting recent advances in diagnosis, treatment, prevention make now the most interesting time to research and learn about Leishmaniasis. [web.stanford.edu]

1. De Vries HJC, Reedijk SH, Schallig HDFH. Cutaneous Leishmaniasis: Recent Developments in Diagnosis and Management. Am J Clin Dermatol. 2015;16(2):99-109.
2. Palumbo E. Treatment strategies for mucocutaneous leishmaniasis. J Glob Infect Dis. 2010;2(2):147-150.
3. McGwire BS, Satoskar AR. Leishmaniasis: clinical syndromes and treatment. QJM. 2014;107(1):7-14.
4. Masmoudi A, Hariz W, Marrekchi S, Amouri M, Turki H. Old World cutaneous leishmaniasis: diagnosis and treatment. J Dermatol Case Rep. 2013;7(2):31-41.
5. Markle WH, Makhoul K. Cutaneous leishmaniasis: recognition and treatment. Am Fam Physician. 2004;69(6):1455-1460.
6. Davies CR, Kaye P, Croft SL, Sundar S. Leishmaniasis: new approaches to disease control. BMJ. 2003;326(7385):377-382.
7. Lemrani M, Hamdi S, Laamrani A, Hassar M. PCR detection of Leishmania in skin biopsies. J Infect Dev Ctries. 2009;3(2):115-122.