title: Cutaneous leishmaniasis in Syria: clinical features, current status and the effects of war.
abstract: Cutaneous leishmaniasis (CL) is a worldwide disease caused by an infection with the protozoan parasite Leishmania transmitted via sand flies. It is endemic in many of the poorest countries of all continents. "Aleppo boil" is one of the recognised names given to this disease in the medical literature. Although CL used to be well-controlled and well-documented in Syria, its incidence has dramatically increased since the beginning of the war; however, there is lack of documentation. Here, we present the past and current epidemiological situation of the disease in Syria. We also draw attention to gross and highly unusual clinical variants of CL presented to the Department of Dermatology in Aleppo covering the important differential clinical diagnoses, since this disease is already known to mimic other conditions. Diagnostic procedures and treatment as well as prevention are summarised. Due to the increased ability to travel, and especially the flight of Syrians to neighbouring countries, as well as to Europe, CL may become a new threat in formerly unaffected regions. Through this account, we hope to give weight to the aspiration that CL does not remain a neglected and often clinically overlooked tropical dermatosis.
authors.affiliation: Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Hospital, Ruprecht-Karls University, Thibautstrasse 3, DE-9115 Heidelberg, Germany. kinan.hayani@med.uni-heidelberg.de.
authors.forename: Kinan
authors.initials: K
authors.lastname: Hayani
authors.forename: Anwar
authors.initials: A
authors.lastname: Dandashli
authors.forename: Elke
authors.initials: E
authors.lastname: Weisshaar
mesh_terms: D000293:Adolescent; D000977:Antiparasitic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D049671:History, 18th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000453:epidemiology* / Q000266:history / Q000469:parasitology / Q000628:therapy / Q000635:transmission; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013593:Syria / Q000453:epidemiology; D013997:Time Factors; D014857:Warfare; D055815:Young Adult
chemical_list: D000977:Antiparasitic Agents