This protocol covers the management of cutaneous leishmaniasis presenting as a clinically simple case — an immunocompetent patient with one or a few small skin lesions on nonexposed skin, caused by a Leishmania species that carries no significant risk of mucosal spread, and with no mucosal involvement present.
Cutaneous leishmaniasis defined as clinically simple: caused by a Leishmania species not associated with mucosal leishmaniasis; no mucosal involvement; only a single or a few small skin lesions (diameter <1 cm) on nonexposed skin; immunocompetent host.
By 4–6 weeks after treatment, the lesion should have decreased in size by more than 50%, ulcerative lesions should be reepithelializing, and no new lesions should be appearing. Ulcerative lesions are generally fully healed by approximately 3 months.
DOI: 10.1093/cid/ciw670
We recommend that immunocompetent persons with skin lesions that are caused by infection with Leishmania species that are not associated with increased risk for ML, that are defined as clinically simple lesions (Table 1), and that are healing spontaneously may be observed without treatment if the patient concurs with this management.
Local therapy is preferred for treatment of Old World cutaneous leishmaniasis (OWCL) lesions defined as clinically simple (Table 1) and may be useful for localized NWCL caused by Leishmania species not associated with increased risk for ML.
Eschar(s) overlying ulcers should be debrided before administration of local therapy and any secondary infection managed to maximize treatment effect.
By 4–6 weeks after treatment, the lesion size should have decreased by >50%, ulcerative lesions should be reepithelializing, and no new lesions should be appearing.
Ulcerative lesions are generally fully reepithelialized and clinically healed by approximately 3 months after treatment.
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