UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD
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The cutaneous leishmaniases include a spectrum of self healing and chronic disease forms caused by protozoan parasites of the genus Leishmania. Clinical presentations differ according to parasite burden and host immune response. Although there can be considerable overlap of clinical presentations, 5 distinct cutaneous syndromes are recognized in Leishmania infections 1 simple or localized ulcerative or nodular cutaneous leishmaniasis CL 2 mucosal leishmaniasis ML 3 leishmaniasis recidivans LR 4 diffuse cutaneous leishmaniasis DCL and 5 post-kala-azar dermal leishmaniasis PKDL. Immunocompromised patients may have atypical presentations. Oligoparasitic low parasite burden syndromes are chronic, persistent infections that follow primary ulcerative disease ML and LR or drug therapy for kala-azar early forms of PKDL. Polyparasitic syndromes such as ulcerative and nodular CL, DCL, and late or nodular PKDL are characterized by a high parasite burden.