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Samuel T. Darling, M.D.
JAMA. 1923;80(17):1260-1261. doi:10.1001/jama.1923.02640440074027.
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To the Editor:  —The illustrations in Dr. Lambert's paper on Oriental Sore (The Journal, April 7, p. 986) show very well the location of the lesions on the back of the elbow and ankle in certain types of the sore. Curiously, these are the favorite sites of the bites of Stegomyia fasciatus (Aedes argenteus), and it is not unlikely that Stegomyia may under certain circumstances impart this infection when infected with a flagellate of this class (Herpetomonas). The diagnosis of dermal leishmaniasis in America is usually confined to communities in which laboratories for diagnosis are available and routine examinations with the microscope practiced. No doubt this infection will be encountered in the warmer southern tier of states when it is thoroughly searched for.The nature of the lesion—its specific character—has been overlooked because of its polymorphous appearance. Aleppo button is perhaps the classical type, but lesions spreading like lupus, or


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