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With troops in Afghanistan and the Middle East, and with tourists traveling throughout the globe, dermatologists may well encounter cutaneous leishmaniasis in their practices. As indicated in this extensive review article, the condition is caused by parasites of the Leishmania genus. These protozoa infect numerous mammals and are transmitted to humans by at least 30 species or subspecies of sandfly. Leishmaniasis is endemic in 70 countries, with 90% of cases occurring in Afghanistan, Algeria, Brazil, Pakistan, Peru, Saudi Arabia, and Syria. In the Old World (Africa, Europe, and Asia), disease develops primarily in semi-arid or desert areas, whereas leishmaniasis in the Americas typically develops in forested areas.
Cutaneous disease begins a…