Cutaneous Leishmaniasis in a Non-endemic Area in Mexico

Leishmaniasis is a zoonotic disease caused by a parasite of the genus Leishmania endemic in 102 countries around the world. Clinical features can be classified as cutaneous, mucocutaneous, and visceral leishmaniasis; this will depend on the species of leishmania responsible for the disease and the immunologic response of the host. We present the case of a 14-year-old male who started with a small papular lesion in the helix of the left ear, which later spread to the rest of the helix, tragus, and part of the auricular concha. On physical examination, an erythematous plaque with a scale that deforms the auricular surface was observed. In histopathology, acute and chronic inflammatory processes were observed with an accumulation of macrophages that contain amastigotes inside (Leishman Donovan bodies). The diagnosis of leishmaniasis represents a challenge in non-endemic regions. It is important to ask about travel history to endemic areas and perform assays to confirm the diagnosis and initiate treatment to prevent mortality and morbidity.