Cutaneous Leishmaniasis

Cutaneous leishmaniasis is a parasitic skin infection transmitted by the bite of infected sandflies, causing skin sores that can range from minor to disfiguring. It's found in parts of the Middle East, Central and South America, Africa and southern Europe.

It's caused by Leishmania parasites transmitted through the bite of infected female sandflies, typically in warm climates where these insects are common. Travellers to endemic areas, particularly those spending time outdoors at dusk or night, are at higher risk.

Symptoms typically begin with a small bump at the bite site that gradually enlarges into an open sore, sometimes with a raised border, developing over weeks to months after the bite. Sores are usually painless unless secondarily infected.

Most cases are limited to the skin and, while they can leave scarring, aren't life-threatening. Rarely, some species can spread to mucous membranes causing more serious disfiguring disease, which is why species identification and appropriate treatment matter.

No, it's caused by parasitic infection transmitted by sandfly bites rather than being inherited. Individual immune response can influence how the infection presents and progresses.

Yes, many cases resolve on their own over months, though this can leave scarring, and active treatment can speed healing and reduce scarring, particularly for larger or cosmetically significant sores. Treatment choice depends on the specific parasite species and lesion characteristics.

Treatment options include topical or injected antimonial medications, oral antifungal or antiparasitic drugs, or physical treatments like cryotherapy or heat therapy for smaller lesions. Your specialist will choose treatment based on the lesion size, location, and identified parasite species.

Diagnosis typically involves taking a sample from the edge of the sore for microscopic examination or specialised testing to identify the parasite, alongside travel history to an endemic area. Species identification helps guide the most appropriate treatment choice.

Cutaneous leishmaniasis is confined to the skin, causing localised sores, while visceral leishmaniasis is a more serious systemic infection affecting internal organs including the spleen, liver and bone marrow, and can be life-threatening without treatment. The two are caused by different Leishmania species with different clinical behaviour.

A non-healing skin sore after travel to an endemic area should be assessed by a tropical medicine or dermatology specialist. Private consultations can typically be arranged within about two weeks, considerably faster than standard NHS waiting times.