Unusual presentations of cutaneous leishmaniasis in clinical practice and potential challenges in diagnosis: a comprehensive analysis of literature reviews

Cutaneous leishmaniasis is regarded as a re-emerging disease due to its increase in spread and rate of transmission over the past decade due to a proportionate increase in global human movements. This study was therefore carried out to review epidemiology, laboratory diagnosis and treatment with in-depth discussion on some of the rare clinical presentations of the disease capable of influencing its control. The study was based on literature review on clinical and laboratory features of cutaneous leishmaniasis from original research articles, review articles, short communications, letters to editor and case reports on the disease for the past 10 years (April 2000 to April 2010). The results were analysed using simple descriptive methods. The rarest presentations of leishmaniasis encountered were peritibial ulcérations, hard painful nipple in a male, swollen upper lip, dermatofibro sarcoma protuberans, sternal proliferative growth, turban tumour, post operative granuloma, chalazion-like 0.00%, and cutaneous sterile pyogranuloma with asymmetrical alopecia 0.00% each. Others include infected sebaceous cysts 0.45%, syphilis 0.19%, yaws 0.13%, thrombotic ulcérations 0.40%, mycetoma 0.90%, sarcoidosis 0.67%, painless nasal solitary nodule 0.00%, tuberculous lymphadenopathy 0.25% and unilateral erythema nodosum 0.28%. Physicians practicing in cutaneous leishmaniasis endemic, but most especially in the non-endemic areas should bear in mind that the disease may not be that rare in the context of the present global village phenomenon; and that, the next case could just be that of cutaneous leishmaniasis, the clinical picture of the patient notwithstanding.