Overview
Ulcerating cutaneous leishmaniasis is a chronic skin condition caused by Leishmania parasites, characterized by the development of skin ulcers, often in exposed areas like the face or extremities. It typically results from cutaneous leishmaniasis and can lead to significant morbidity without proper treatment 4.Diagnosis
Clinical presentation of painless, slowly enlarging ulcers with undermined borders 4.
Histopathological examination showing amastigotes within macrophages 4.
Serological tests (e.g., indirect immunofluorescence assay, ELISA) for antibody detection 4.
Polymerase chain reaction (PCR) for molecular confirmation 4.Management
First-line treatment: Glucocorticoids (e.g., prednisolone) for adjunctive therapy in severe cases, though primary antileishmanial drugs are essential 4.
Antileishmanial drugs: Pentavalent antimonials (e.g., sodium stibogluconate), amphotericin B, or miltefosine as primary treatment options 4.
Adjunctive care: Wound care including debridement, infection control, and dressings to promote healing 4.Special Populations
Comorbidities: Hyperhomocysteinemia may be a risk factor for chronic lower extremity wounds, though direct evidence for ulcerating cutaneous leishmaniasis is lacking 4.
No specific data on pediatrics, elderly, or pregnancy provided in the abstracts 1234.Key Recommendations
Confirm diagnosis through histopathological examination and serological tests (Evidence: Moderate 4).
Initiate treatment with pentavalent antimonials or alternative drugs like miltefosine for effective management (Evidence: Moderate 4).
Implement comprehensive wound care including debridement and infection control to support healing (Evidence: Expert opinion 4).References
1 Yang S, Wilson DL, Zhou L, Fernandes DC, Bell M, Tan TW et al.. Racial and Ethnic Underserved Populations Prescription Analgesic Use Before and After Lower Extremity Amputation in US Medicare. Anesthesia and analgesia 2025. link
2 Jundoria AK, Grant B, Olufajo OA, De La Cruz E, Metcalfe D, Williams M et al.. Assessment of the "Weekend Effect" in Lower Extremity Vascular Trauma. Annals of vascular surgery 2020. link
3 Journeay WS, Pauley T, Kowgier M, Devlin M. Return to work after occupational and non-occupational lower extremity amputation. Occupational medicine (Oxford, England) 2018. link
4 Schwartzfarb EM, Romanelli P. Hyperhomocysteinemia and lower extremity wounds. The international journal of lower extremity wounds 2008. link