New World Cutaneous Leishmaniasis — photos

Symptoms and syndromes in photos

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New World cutaneous and mucocu­taneous leishmaniasis occur focally throughout Central America and South America as far south as Sao Paulo State of Brazil. The disease is limited by the Andean chain to the West except in Peru where a special form of cutaneous disease 'Uta' is found in the Western slopes of the Andes.

Distribution (including Espundia)

Distribution (including Espundia).

Cutaneous lesions in Panama.

Photo 1. Cutaneous lesions in Panama. The cutaneous disease in Panama sometimes shows evidence of lymphatic spread rather similar to the form seen in the Guyanas which is known there as 'Pian hois'. The picture illustrates lymphatic swelling proximal to a cutaneous ulcer. The causative organism is L. b. panamensis.

Healed simple cutaneous lesions.

Photo 2. Healed simple cutaneous lesions. Simple, single ulcers similar to those of Oriental sore caused by organisms of the L. mexicana group usually heal readily without complications.

Residual infection in 'healed' lesions.

Photo 3. Residual infection in 'healed' lesions. Occasionally an apparently healed ulcer such as this may be found on biopsy to contain living organisms. Such cases are associated with a constant positive FAT titre. It is suspected that mucocutaneous disease may sometimes arise after many years as a result of metastasis from lesions of this type.

Chiclero's ulcer.

Photo 4. Chiclero's ulcer. Forest workers collecting gum from wild chicle trees commonly sleep near the forest floor and are bitten on exposed parts of the head by vectors that normally maintain transmission of L. mexicana among the forest rodents. Ulcers leading to erosion of the auricular cartilage are known as 'chiclero's ulcers'.

Metastatic type of simple sore.

Photo 5. Metastatic type of simple sore. Occasionally multiple ulcers, each of the typical Oriental sore type, and all of the same age, appear to develop as a result of direct metastasis from an infected macrophage that becomes disrupted while in the peripheral circulation.

Rodent reservoirs of Brazilian rain forest.

Photo 6. Rodent reservoirs of Brazilian rain forest. Most cutaneous leishmaniasis in the New World is a zoonosis associated with rodents of the rain forest. Rodents S|4ch as Proechimysguyanensis are typical animal reservoirs for forest leishmaniasis in both Brazil and Central America. L. mexicana amazonensis has been isolated from this species. The Brazilian rain forest is the typical habitat of L. m. amazonensis.

Animal reservoirs in Panama.

Photo 7. Animal reservoirs in Panama. In Panama a wide variety of animals serve as reservoirs for L. b. panamensis. The hosts include species of monkeys, marmosets, and even such bizarre animals as the three-toed sloth shown here.

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