Tuberculoid Cutaneous Leishmaniasis: Pathogenesis, Clinical Features, Diagnosis and Modern Treatment Approaches

Tuberculoid cutaneous leishmaniasis is a chronic granulomatous form of cutaneous leishmaniasis characterized by persistent skin lesions, low parasite burden, and strong cell-mediated immune response. The disease usually develops after healing of primary cutaneous leishmaniasis and clinically resembles cutaneous tuberculosis, sarcoidosis, lupus vulgaris, and other granulomatous dermatoses. Tuberculoid leishmaniasis remains an important public health problem in endemic regions of Asia, the Middle East, Africa, and Latin America. Delayed diagnosis and inappropriate treatment may lead to chronic inflammation, scarring, cosmetic deformities, and psychological consequences. This article reviews the epidemiology, etiology, immunopathogenesis, clinical manifestations, diagnostic approaches, differential diagnosis, complications, and modern therapeutic strategies of tuberculoid cutaneous leishmaniasis. Special attention is given to advances in molecular diagnostics, histopathological findings, and current pharmacological management.