Cutaneous Leishmaniasis Encountered in Philadelphia

Abstract

Four cases of cutaneous leishmaniasis, one due to<i>Leishmania braziliensis</i>, acquired in Guatemala, and three due to L tropica, probably acquired in Israel. In three of the patients with oriental sore, the majority of lesions were on the legs, and one of varying size and development on the hand. All lesions resolved within one year without therapy. In the American cutaneous case the picture was that of chiclero ulcer. All four patients reacted to a common antigen prepared from L<i>tropica</i>, indicating cross reactivity. Gradual transition from an acute inflammatory process with many Leishman-Donovan organisms to a granulomatous lesion with few or no organisms occurred. Physicians should advise prophylactic use of repellents and insecticides for patients traveling to endemic areas. In all likelihood this would decrease the probability of acquiring this insect-borne disease.