Cutaneous leishmaniasis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
History and Symptoms
CL is characterized by skin lesions (open or closed sores), which typically develop within several weeks or months after exposure. In some people, the sores first appear months or years later, in the context of trauma (such as skin wounds or surgery). The sores can change in size and appearance over time. They typically progress from small papules to nodular plaques, and eventually lead to open sores with a raised border and central crater (ulcer), which can be covered with scales or crust. The lesions usually are painless but can be painful, particularly if open sores become infected with bacteria. Satellite lesions, regional lymphadenopathy (swollen glands), and nodular lymphangitis can be noted. The sores usually heal eventually, even without treatment. However, they can last for months or years and typically result in scarring.
Another potential concern applies to some of the Leishmania species in South and Central America—occasionally, these parasites spread from the skin to the mucosal surfaces of the nose or mouth and cause sores there. This form of leishmaniasis, mucosal leishmaniasis (ML), might not be noticed until years after the original skin sores appear to have healed. Although ML is uncommon, it has occurred in travelers and expatriates whose cases of CL were not treated or were inadequately treated. The initial clinical manifestations typically involve the nose (chronic stuffiness, bleeding, and inflamed mucosa or sores) and less often the mouth; in advanced cases, ulcerative destruction of the nose, mouth, and pharynx can be noted (such as perforation of the nasal septum).