Cutaneous Leishmaniasis in Erbil Governorate: Clinical manifestations and disease course

Background: Cutaneous leishmaniasis (CL) is an infectious disease of zoonotic characteristic; its etiological agent is a protozoan of Leishmania species. This infectious agent is transmitted to humans through a secondary vector, which is infected sand-fly. According to WHO report, Iraq is a country where cutaneous leishmaniasis is an emerging disease, especially, its rural areas are labeled to be the source of the infection and endemicity. Course of the disease and treatment is highly defined by the subtype of cutaneous leishmaniasis and its species. Methods: Data were collected from cutaneous leishmaniasis registry database of Erbil Dermatology Teaching Center in city of Erbil from August 2016 to August 2017. The collected data were descriptively analyzed for the clinical manifestations and the course of disease in the outbreak of this disease in Erbil governorate. Results: A total of 124 patients were enrolled in this study. Among them, 93 (75%) were male and 31 (25%) were female. Their age ranged from 2 years to 73 years, with the mean age of 30.7±11.3. The majority of the patients were members of army forces. The total number of the lesions was 325. The number of lesions being ulcerated at the time of presentation was 179 (55%) and non-ulcerated lesions 146 (45%). Time needed for improvement ranged from 1.5 to 4.8 months. Recovery time of cutaneous leishmaniasis lesions from time of onset to the remission ranged from 1.3 to 14.3 months. Conclusion: The complete recovery time of the CL lesions was longer than what has been mentioned previously in Iraq. Ulceration of the lesions depends on the diameter of the lesions, as increased diameter increases the possibility of the ulceration. The possibility of lesion ulceration increases with an increase in the diameter of the lesions. Considering the observations in different clinical patterns and course of this disease, further studies should be conducted to identify CL species.