Non-healing facial lesions: cutaneous old world leishmaniasis in dresden

Cutaneous leishmaniasis is a common vector-borne disease world-wide but not in Central Europe. The typical clinical manifestation is an enlarging papule on the site of infection. Vectors are sandflies and reservoirs may be wild animals like rodents, dogs or even humans. Patients with any kind of immunodeficiency are at risk. We report on two otherwise healthy patients, 16 and 18 years-of-age, who presented non-healing facial lesions. The diagnosis of cutaneous leishmaniasis was confirmed through intracellular amastigotes in Giemsa stains of skin biopsies. One infection was of Syrian origin and the other was contracted in Tuscany. Since both lesions were classified as complex cutaneous lesions, drug therapy was initiated with itraconazole orally or intralesional meglumine antimonite. A complete response was obtained in both patients. No other adverse effects rather than injection pain with meglumine antimonite were observed. We should be aware of cutaneous leishmaniasis in travelers returning from endemic regions or from migrants and refugees from endemic regions.