Erysipeloid leishmaniasis: an unusual clinical presentation.

Old World cutaneous leishmaniasis has many different clinical presentations. A rare and unusual presentation of cutaneous leishmaniasis is the erysipeloid type. This clinical form is not only unusual in its clinical features but also in the specific category of patients it seems to afflict. In this report 5 Iranian patients, predominantly females, between 50 and 70 years of age, presented with infiltrative erythematous lesions covering the center of the face and resembling erysipelas. Skin smears and/or skin biopsies revealed the diagnosis of cutaneous leishmaniasis. The reason for this type of presentation is unclear, although factors such as the specific species involved, the host's immune response, the hormonal changes encountered with increasing age, and the changes in skin barrier with ageing can be speculated as being important points in causing such an unusual presentation.