Treatment of Cutaneous Leishmaniasis With Cryosurgery and Itraconazole: A Case Report

Cutaneous leishmaniasis is an endemic parasitic disease in parts of Latin America, caused by various Leishmania species. While pentavalent antimonials are considered first-line treatment, their toxicity and limited availability in some regions necessitate alternative therapeutic strategies. We present a 25-year-old immunocompetent male who developed four painless, erythematous-violaceous lesions one month after travel to Tulum, Mexico. The lesions measured between 0.8 and 2.5 cm and were located on the ear, axilla, and back. Direct smear and molecular techniques confirmed infection by Leishmania mexicana. The patient was treated with oral itraconazole (200 mg/day for three months) and two cryotherapy sessions performed four weeks apart. Complete clinical resolution was achieved and sustained at one-year follow-up. This case highlights the effectiveness of combining itraconazole and cryotherapy for cutaneous leishmaniasis due to L. mexicana, particularly in settings with limited access to standard therapies. Early diagnosis and individualized treatment approaches can optimize patient outcomes.