[Leishmaniasis]

Leishmaniasis is a globally rising parasitic disease. In Germany, it mainly affects travelers returning from endemic areas such as the Mediterranean region. It is caused by single-celled Leishmania parasites, which enter the skin through the bite of sandflies and multiply within the host's cells. Clinical presentation varies significantly depending on the pathogen species and the patient's immune status-ranging from the visceral form to various cutaneous manifestations (localized cutaneous, diffuse cutaneous, mucocutaneous). Cutaneous leishmaniasis often manifests with a delay of several weeks: it begins as a small papule and can develop into an ulcer. While some lesions heal after several months leaving scars, others develop into chronic wounds. If suspected, a skin biopsy should always be taken and analyzed in a specialized laboratory using histology and PCR. For individually tailored treatment-whether local or systemic-factors such as the pathogen species, the number and location of skin lesions, and the patient's immune status are crucial. A modern, well-tolerated vaccine is currently not available.