Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Figures & data

Figure 1. Clinical forms of tegumentary leishmaniasis.

(A) Localized cutaneous leishmaniasis presenting single ulcer on the leg (reprinted with permission from Luiza K Oyafuso, Instituto de Infectologia Emilio Ribas de São Paulo, Brazil). (B) Leishmaniasis recidiva cutis presenting papules and vesicles around the healed lesion of cutaneous leishmaniasis on the leg (reprinted with permission from Jackson ML Costa, Universidade Federal do Maranhão, Brazil). (C) Disseminated cutaneous leishmaniasis presenting numerous ulcers on the face (reprinted with permission from Jackson ML Costa). (D) Diffuse cutaneous leishmaniasis presenting infiltrated nodules on the arms and thorax (reprinted with permission from Fernando T Silveira, Universidade Federal do Pará-Brazil, Brazil). (E) Diffuse cutaneous leishmaniasis presenting infiltrated nodules on the ear (reprinted with permission from Fernando T Silveira). (F) Mucosal leishmaniasis with destructive lesion in the nose (reprinted with permission from Luiza K Oyafuso). (G) Atypical cutaneous leishmaniasis in a HIV-infected patient presenting multiple ulcers on the legs and feet. (H) Atypical cutaneous leishmaniasis in HIV-infected patient presenting erythematous plaques on the back, and (I) atypical cutaneous leishmaniasis in a HIV-infected patient presenting ulcers on the scrotum and penis.

Images G, H and I reproduced from [28] with permission from Wiley-Blackwell.

Table 1. Recommended doses of first-line drugs to treat tegumentary leishmaniasis according to the WHO and the Ministry of Health of Brazil.

Clinical form	Pentavalent antimonial			Amphothericin B			Pentamidine
	WHO	Brazil		WHO	Brazil		WHO	Brazil
Localized cutaneous leishmaniasis	20 mg/kg/day for 20 days	10–20 mg/kg/day (15 mg/kg/day) for 20 days		NA	1 mg/kg/day Total dose: 1–1.5 g		4 mg/kg/day	4mg/kg/day Maximum total dose: 2.0 g
Disseminated cutaneous leishmaniasis	20 mg/kg/day for 20 days	10–20 mg/kg/day for 20 days		NA	1 mg/kg/day Total dose: 1–1.5 g		NA	4 mg/kg/day Maximum total dose: 2.0 g
Diffuse cutaneous leishmaniasis	20 mg/kg/day for 20 days	20 mg/kg/day for 20 days		NA	1 mg/kg/day Total dose: 1–1.5 g		NA	NA
Mucosal leishmaniasis	NA	20 mg/kg/day for 30 days		NA	1 mg/kg/day Total dose: 2.5–3 g		NA	4 mg/kg/day Maximum total dose: 2.0 g

NA: Not available.

Lindoso JA, Barbosa RN, Posada-Vergara MP et al. Unusual manifestations of tegumentary leishmaniasis in AIDS patients from the New World. Br. J. Dermatol.160, 311–318 (2009).

 PubMed Web of Science ®Google Scholar