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Johannes A. Blum, Christoph F. Hatz, Treatment of Cutaneous Leishmaniasis in Travelers 2009, Journal of Travel Medicine, Volume 16, Issue 2, 1 March 2009, Pages 123–131, https://doi.org/10.1111/j.1708-8305.2008.00286.x
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Leishmaniasis is an infection caused by intracellular protozoan parasites of the genus Leishmania and it is transmitted by various species of sand flies. Apart from disseminated visceral leishmaniasis (kala azar), nodules, patches/plaques, ulcerative skin lesions, and destructive mucosal inflammation comprise the wide range of clinical manifestations. With regard to cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML), the parasite species are divided into Old World (Southern Europe, the Middle East, Asia, and Africa) and New World leishmaniasis (Latin America). While most of the Old World species cause benign cutaneous disease, a variety ranging from mild cutaneous disease to severe mucosal lesions is seen among the American species.
CL is one of the 10 leading presentation diseases among tourists from tropical countries with skin diseases and was found in 3% of travelers with skin disorders. 1 Because of the broad clinical spectrum of CL and resemblance with common skin diseases such as bacterial or fungal infections and tumors, the correct diagnosis is initially often missed. However, a delayed diagnosis may lead to mucosal spread. Furthermore, treatment of the various species may be different and a suboptimal treatment may cause a prolonged course of the disease and may be associated with disfiguring scars. 2,3