Overview

Leishmaniasis is a disease transmitted through the bites of infected female sandflies.

Cutaneous leishmaniasis is the most common form of the disease. It causes skin lesions, mainly ulcers, on exposed parts of the body which can leave life-long scars and cause serious disability or stigma.

Symptoms

Cutaneous leishmaniasis begins with a small bump that develops into a sore and then an open, oozing ulcer.

The sore is often very painful and usually appears on a person’s face, arms or legs.

Individuals exhibiting symptoms should immediately seek medical attention.

A health worker should assess symptoms to confirm the diagnosis.

Treatment

Cutaneous leishmaniasis is treatable and curable.

It can be treated with different therapeutic options, including local (applied directly to the lesion), systemic (affecting the entire body) and physical treatments such as cryotherapy (freezing the lesion) and thermotherapy (using heat to treat the lesion).

To determine the most appropriate treatment, collect clinical information on the size of the lesion, the number and location of lesions on the body, and the evolution of the lesions (e.g. duration, aggravation and improvement), as well as the immunological and general health status of the patient, including whether immunocompromised or not, and the presence of diabetes, heart, liver or kidney problems.

Prevention

In addition to treating individuals, steps should be taken to reduce the spread of the disease. Individuals and communities can reduce risk by avoiding sandfly bites. Simple measures include:

Wearing protective clothing that covers the skin, such as long-sleeved shirts and pants, especially during peak biting times (dusk and dawn).

Using insect repellent on exposed skin, especially during peak biting times.

Using bed nets to avoid bites when sleeping. Insecticide-treated bed nets are recommended. They offer effective protection against sandflies which are smaller than mosquitoes and can penetrate regular bed nets. In emergency situations, it is crucial to use a bed net for some level of protection. Keep surrounding areas free of debris to reduce insect habitats.

Use screens on windows and doors to keep sandflies out. Where windows and doors are not present, create makeshift barriers and enclosures to minimize exposure to sandflies.

Keep indoor areas well-lit. Sandflies are attracted to dark areas.

Spray living/sleeping areas with an insecticide.

Immediately report any increase in people with signs and symptoms of leishmaniasis to local health authorities or a community health worker.

Sources

Factsheets: leishmaniasis. Geneva: World Health Organization; 2023 (https://www.who.int/news-room/fact-sheets/detail/leishmaniasis).

Health topics: leishmaniasis. Geneva: World Health Organization; 2024 (https://www.who.int/health-topics/leishmaniasis#tab=tab_1).

Manual for case management of cutaneous leishmaniasis in the WHO Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean; 2014 (https://www.who.int/publications/i/item/9789290219453).

Operational manual on leishmaniasis vector control, surveillance, monitoring and evaluation. Geneva: World Health Organization; 2022 (https://www.who.int/publications/i/item/9789240060340).