title: Cutaneous and mucocutaneous leishmaniasis: Differential diagnosis, diagnosis, histopathology, and management.
abstract: The diagnosis of leishmaniasis can be challenging because it mimics both infectious and malignant conditions. A misdiagnosis may lead to an unfavorable outcome. Using culture, histologic, and/or polymerase chain reaction study results, a diagnosis of leishmaniasis can be established and treatment initiated. Appropriate management requires an accurate diagnosis, which often includes identification of the specific etiologic species. Different endemic areas have varying sensitivities to the same medication, even within individual species. Species identification may be of practical value, because infections with select species have a substantial risk of visceral involvement. In addition, HIV and otherwise immunocompromised patients with leishmaniasis have a propensity for diffuse cutaneous leishmaniasis. For most New World Leishmania species, parenteral antimonial drugs remain the first line of therapy, while Old World species are easily treated with physical modalities. Historically, live organism vaccination has been used and is effective in preventing leishmaniasis, but results in an inoculation scar and an incubation period that may last for years. A more effective method of vaccination would be welcome.
authors.affiliation: Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey.
authors.forename: Marc Z
authors.initials: MZ
authors.lastname: Handler
authors.affiliation: Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey.
authors.forename: Parimal A
authors.initials: PA
authors.lastname: Patel
authors.affiliation: Infectious Diseases, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Kapila
authors.affiliation: Dermatology, Taiz University School of Medicine, Yemen.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Al-Qubati
authors.affiliation: Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey; Rutgers School of Public Affairs and Administration, Newark, New Jersey. Electronic address: roschwar@cal.berkeley.edu.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schwartz
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D004359:Drug Therapy, Combination; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D015994:Incidence; D007891:Leishmania / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D007897:Leishmaniasis, Mucocutaneous / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D016896:Treatment Outcome; D014329:Tropical Climate
chemical_list: D000981:Antiprotozoal Agents; D000666:Amphotericin B
keywords: CDC; HIV; Leishmaniasis; antimony; carbon dioxide slush; ketoconazole; miltefosine; protozoa; sodium stibogluconate; tropical disease; vaccination; vaccine