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Erysipeloid Cutaneous Leishmaniasis in the Old World: A Systematic Review
Hossein Mortazavi1, Alireza Firooz2, Alireza Khatami2,3
1Department of Dermatology, Tehran University of Medical Sciences, Razi Hospital, Tehran, Iran.
International Journal of Dermatology
|November 26, 2025
Summary
Erysipeloid cutaneous leishmaniasis (ECL) predominantly affects elderly women, often presenting on the face. Postmenopausal status and advanced age may increase susceptibility to this rare leishmaniasis form.
Area of Science:
- Dermatology
- Infectious Diseases
- Parasitology
Background:
- Erysipeloid cutaneous leishmaniasis (ECL) is a rare clinical manifestation of leishmaniasis.
- It classically presents with erythematous, infiltrated lesions, typically on the face.
Purpose of the Study:
- To systematically review demographic, clinical, and treatment data of ECL in the Old World.
- To define clinical distributions of ECL based on lesion location.
Main Methods:
- Systematic literature search using specific keywords across major scientific databases.
- Inclusion of studies reporting ECL cases from the Old World.
- Classification of ECL based on lesion location: centrofacial, facial/scalp, or trunk/extremities.
Main Results:
- A total of 103 patients were included, with 70.9% females and a mean age of 52.1 years.
- Centrofacial lesions were most common (72 patients), predominantly affecting females (83.8%), especially postmenopausal women.
- Pentavalent antimonials were the primary treatment for 63.1% of patients.
Conclusions:
- ECL is a rare form of cutaneous leishmaniasis, predominantly affecting elderly women and typically localized to the mid-face.
- Advanced age and menopause may be predisposing factors for ECL.
- Early clinical suspicion is crucial for diagnosing ECL in endemic areas.
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