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Mucocutaneous leishmaniasis is a skin disease caused by parasitic infection with organisms carried by sand flies. There are several different forms of leishmaniasis, found primarily in South America and the Middle East, and the mucocutaneous form appears to be most common in South America. It is also very ancient; very old Incan artwork depicts people with skin lesions that are characteristic of this condition. Treatment is available, and it is important to pursue treatment to avoid tissue death and the potential for disfigurement.
A case of mucocutaneous leishmaniasis starts with a sand fly bite. The parasites burrow into the skin, creating a small lesion around the bite site, followed by large ulcerations. These can take months to years to develop. Research on the condition suggests that it may have a genetic component, as some populations appear more vulnerable than others, and the immune system plays a role in determining whether, and when, the lesions will appear.
This form of leishmaniasis attacks the mucous membranes around the nose and mouth, although lesions can appear anywhere on the body. Patients with mucocutaneous leishmaniasis can have difficulty breathing and eating because of the open sores, and will usually experience discomfort and social awkwardness because the sores will be highly visible. As the lesions grow, they can be prone to infections with other organisms. This will cause tissue death around the site, leading to scarring and pitting. Untreated lesions can spread through the skin to cover the whole face.
Medications to treat mucocutaneous leishmaniasis are available. These drugs must be taken in a complete cycle while the patient practices a skincare regimen to encourage the lesions to heal. They should start to resolve after the parasites are eradicated, although patients may experience scarring and other marks even after the lesions close. As of 2011, researchers were still at work on vaccines to prevent leishmaniasis infection.
There are some measures available to reduce the risk of mucocutaneous leishmaniasis infection. Sleeping under insect nets and wearing insect repellent will minimize the chances of a bite. Travelers who notice insect bites should clean the area well and pay attention to early signs of lesions that might indicate leishmaniasis or other infections. When seeking treatment for skin lesions in regions where this disease is not endemic, patients with a history of travel in South America and the Middle East should make their doctors aware, otherwise the doctor may not consider leishmaniasis as a potential diagnosis.
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