The Clinical Phenotypes of Cutaneous Leishmaniasis in Central and Southwest Regions of Yemen

BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in Yemen. CL displays a spectrum of typical and atypical morphologies yet understudied in the central and southwest regions of Yemen. AIMS AND OBJECTIVES: To identify the typical and atypical clinical phenotypes of CL in the central and southwest regions of Yemen. MATERIALS AND METHODS: A survey of 145 patients who visited Prof. Al-Qubati Clinic in Taiz between 2010 and 2015, was conducted. RESULTS: Children and residents of the rural areas were at high risk of exposure to the insect vector. The typical phenotype was single (67%), facial (58%) and ulcerated nodule (35%). Other usual phenotypes were small ulcers (21.4%) and non-ulcerative papules and nodules (21%). Unusual phenotypes constituted 12% of the cohort and included psoriasiform, eczematous, erysipeloid, lupoid, verrucous, large ulcerative, leishmania recidivens, satellite, granulomatous infiltrative and hyperkeratotic plaques. Mucous membrane involvement was evident in 10.6% and was also polymorphic. CONCLUSION: CL has many morphologic patterns in central and southwest regions of Yemen, some are clinically deceptive.