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Figure 4. Clinical photographs of
Cutaneous Leishmaniasis (CL)
A. Typical New World cutaneous leishmaniasis (NWCL) ulcerative lesion caused by Leishmania
(Viannia) braziliensis infection acquired in Peru (the patient also had mucosal involvement).
Photograph from Chris Ohl, Wake Forest Univ, NC
B. L. tropica CL, with thick crusted eschar that should be debrided before diagnostic testing or topical
treatment. Photograph from Moshe Ephros
C and D: Before and aer treatment of a L. major lesion, demonstrating the scarring nature of this
infection. Photographs from Naomi Aronson
E. Nodular lesion caused by L. infantum infection, acquired in Sicily. Photograph from Christina
Coyle, Albert Einstein University, NY
F. L. tropica leishmaniasis recidivans, with stereotypical recurrence around the edge of a scar on the
face. Photograph from Moshe Ephros
G and H. Secondary infection of CL lesions: G shows suppurative staphylococcal superinfection, and H
shows impetiginous streptococcal superinfection. Purulence is not typical of CL unless secondarily
infected. Photograph from Naomi Aronson
I. L. mexicana ulcerative lesion of the ear (Chiclero's ulcer), with a superficial necrotic appearance and
edema. Photograph from Naomi Aronson
J. L. (V.) panamensis infection of the eyelid. Photograph from Naomi Aronson
K. Sporotrichoid NWCL; note the subcutaneous nodules along the lymphatic drainage and two large
ulcerative lesions. Photograph from Peter Weina
L. Phlebitic change and large ragged ulcer caused by L. major infection acquired in northern
Afghanistan. Photograph from Naomi Aronson
M. CL lesion over colored tattoo. Photograph from Naomi Aronson
N. Multiple small cicumferential papules that formed soon aer initiation of therapy for a plaque-like
lesion caused by L. major. Photograph from Naomi Aronson
O. Verrucous CL on the tip of the nose of a patient in Afghanistan. Photograph from Peter Weina.
