LEISHMANIASIS is a tropical disease caused by a flagellated protozoan and transmitted to man by various species of phlebotomus flies. Cutaneous, mucocutaneous, and visceral forms occur with no progression from one to another. While the etiological agents are morphologically and culturally identical, the three species of protozoa can be distinguished immunologically. All forms are endemic in tropical and semitropical areas on both sides of the equator.
Cutaneous leishmaniasis, also known as Oriental sore, Delhi boil, and Aleppo button, is confined to the skin and is caused by Leishmania tropica. It is seen in Africa, the Yucatan Peninsula, Mexico, and the Middle East extending from the Mediterranean into southern Russia and India. Cases are reported frequently from new areas.1,2 The disease begins as a small papule which arises at the site of a sandfly bite on exposed skin. The incubation period is usually less than 6 months.3 The initial