Clinical Picture of Cutaneous Leishmaniasis in Isfahan, Iran

BACKGROUND: Cutaneous leishmaniasis caused by Leishmania tropica is endemic in Iran, being the second most prevalent vector-borne disease in the country (after malaria). From the five most infected provinces, Isfahan is third after Boushehr and Khouzestan. METHODS: To study the clinical picture of this disease, 1250 patients referred to the Leishmaniasis Training and Treatment Center (affiliated with Isfahan University of Medical Sciences) were studied during a 2-year period. RESULTS: The disease was more prevalent in the age group of 10-15 years. Nonindigenes had more lesions and their lesions were more acute and more severe than those of indigenes. The face was the most frequent site of involvement (39.7%), followed by the upper (32.4%) and lower extremities (19.4%), whereas only 8.1% of the lesions were found on the trunk. No direct relation was seen with age, sex, and clinical features of the lesions except for the erysipeloid cases that were rare and seen only in middle-aged and elderly women. Noduloulcerative and papular lesions dominated the clinical picture, followed by plaque, impetiginized, and nodular lesions. CONCLUSIONS: The reason why nonindigenous patients have more severe lesions and in greater number is not clear. It can be postulated that nonindigenous people were more exposed to the vector biting since they were living in more infected areas and that during a long period of time, a mild immunity might have developed in indigenous people.