Definition: infection with promastigotes (leptomonads) of Leishmania tropica and of Leishmaniasis major inoculated into the skin by the bite of an infected sandfly, Phlebotomus (commonly P. papatasii); it is endemic to parts of Asia Minor, northern Africa, and India, and is known by innumerable names, including tropical sores, tropical ulcers, and other indications of locality (Aleppo, Baghdad, Delhi, or Jericho boil; Aden ulcer; Biskra button); the ulcer begins as a papule that enlarges to a nodule and then breaks down into an ulcer. Leishmanial cells are seen within histiocytes in hematoxylin and eosin–stained tissue sections. Two distinctive clinical and epidemiologic diseases are recognized: the more common and widespread zoonotic rural disease with a moist acute form, caused by L. major, with reservoir rodent hosts, and an urban, anthroponotic, dry, chronic form of leishmaniasis caused by Leishmaniasis tropica, without a reservoir host, and now largely controlled.
See Also: diffuse cutaneous leishmaniasis
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