Localized cutaneous leishmaniasis imported into Paris: a review of 39 cases

Int J Dermatol. 2004 Feb;43(2):120-5. doi: 10.1111/j.1365-4632.2004.01991.x.


Background: Localized cutaneous leishmaniasis (LCL) is a common cause of dermatosis in travelers returning from the tropics. We describe the epidemiological, clinical, and biological aspects and therapeutic outcome of imported LCL.

Methods: A retrospective study of all cases of LCL observed from 1992 to 2000 in our tropical disease unit. Diagnosis was based on direct examination of skin smear and/or culture with identification of subsequent subspecies.

Results: Thirty-nine cases (25 males, 14 females; median age: 38 years) were included: 35 French travelers and four foreign immigrants; 15 cases were acquired in the Old World and 24 cases in the New World. The patients presented to our department with a median of 60 days after return. Thirteen patients had already consulted general practitioners, and the diagnosis was missed in five cases (38%). Five clusters were identified. The median number of skin lesions was two per patient. Diagnosis was established by direct microscopic examination in 36 cases (92%). Thirty-five patients were assessable for first-line treatment with antimonials (intramuscularly in 18, intralesionally in nine), intramuscular pentamidine isethionate or oral ketoconazole (four patients each). Twenty-five patients (71.4%) were cured. The remaining 10 patients were cured after one to three courses of other treatments. Overall adverse events occurred in 60% of the patients treated with antimonials and 37% of those treated with pentamidine.

Conclusion: Imported LCL is still unrecognized by Western physicians. Clusters may be observed in groups of travelers. The therapeutic outcome is impaired by numerous but minor side-effects.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Animals
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Injections, Intramuscular
  • Leishmaniasis, Cutaneous / diagnosis*
  • Leishmaniasis, Cutaneous / drug therapy
  • Leishmaniasis, Cutaneous / epidemiology*
  • Male
  • Middle Aged
  • Paris / epidemiology
  • Pentamidine / administration & dosage
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Travel*
  • Treatment Outcome


  • Pentamidine