eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
Current issue Archive Manuscripts accepted About the journal Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 36
Original paper

Imported cutaneous leishmaniasis: a 13-year experience of a Polish tertiary center

Anna Kuna, Michał Gajewski, Martyna Bykowska, Halina Pietkiewicz, Romuald Olszański, Przemysław Myjak

Adv Dermatol Allergol 2019; XXXVI (1): 104-111
Online publish date: 2019/02/22
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Leishmaniasis is a vector-borne infection endemic in 98 countries. Its cutaneous form (CL) causes skin lesions on exposed parts of the body and may lead to scarring. The numbers of imported cases of CL are increasing in Europe but the incidence of CL importation in Poland is unknown.

Material and methods
A list of all patients diagnosed with CL at the Department in the years 2005–2017 was obtained. The study presents their data including age, sex, areas visited, purpose of travel, time from the onset of symptoms to correct diagnosis, appearance of lesions, results of impression smears and PCR, and superinfection, if detected, as well as treatment methods and their outcomes.

Altogether, 14 cases of cutaneous leishmaniasis were identified. The study demonstrates an increase in the number of cases of imported CL at our center over the last 5 years. The time to correct diagnosis was long in spite of the fact that the lesions had usually an appearance typical of CL.

Intensified education of physicians and travelers, as well as improvement in the access to travel medicine services and to the diagnosis and treatment methods appropriate for CL, are needed in our country. In our opinion, surveillance of leishmaniasis should be introduced in Poland.


cutaneous leishmaniasis, neglected diseases, imported communicable diseases, emerging communicable diseases, travel-related illness, disease vectors

Showler AJ, Boggild AK. Cutaneous leishmaniasis in travellers: a focus on epidemiology and treatment in 2015. Curr Infect Dis Rep 2015; 17: 489.
Integrating neglected tropical diseases into global health and development: fourth WHO report on neglected tropical diseases. Geneva: World Health Organization 2017.
Reithinger R, Dujardin JC, Louzir H, et al. Cutaneous leishmaniasis. Lancet Infect Dis 2007; 7: 581-96.
Cotton JA. The expanding world of human leishmaniasis. Trends Parasitol 2017; 33: 341-4.
Karimkhani C, Wanga V, Coffeng LE, et al. Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis 2016; 16: 584-91.
Global leishmaniasis update, 2006–2015: a turning point in leishmaniasis surveillance. Wkly Epidemiol Rec 2017; 92: 557-65.
Bailey F, Mondragon-Shem K, Hotez P, et al. A new perspective on cutaneous leishmaniasis – implications for global prevalence and burden of disease estimates. PLoS Negl Trop Dis 2017; 11: e0005739.
Hodiamont CJ, Kager PA, Bart A, et al. Species-directed therapy for leishmaniasis in returning travellers: a comprehensive guide. PLoS Negl Trop Dis 2014; 8: e2832.
Esteva L, Vargas C, Vargas de León C. The role of asymptomatics and dogs on leishmaniasis propagation. Math Biosci 2017; 293: 46-55.
Gradoni L, López-Vélez R, Mokni M. Manual on case management and surveillance of the leishmaniases in the WHO European Region. World Health Organization, Geneva 2017.
Act of December 5, 2008 on preventing and combatting infections and infectious diseases in humans. Appendix 1 (official consolidated text) (2018).
Myjak P, Szulta J, de Almeida ME, et al. Usefulness of PCR method for detection of Leishmania in Poland. Pol J Microbiol 2009; 58: 219-22.
Myjak P, Szostakowska B, Lass A, et al. Diagnostyka leiszmaniozy z uwzględnieniem genotypowania. Diagnosta Lab 2012; 10: 6-10.
Gradoni L. Epidemiological surveillance of leishmaniasis in the European Union: operational and research challenges. Euro Surveill 2013; 18: 20539.
Kotłowski A. Cutaneous leishmaniasis in the light of personal observations with regard to its diagnosis and treatment in tropical countries. Wiad Parazytol 1988; 34: 509-14.
Lejman K. Przypadek leishmaniozy skórnej. Przegl Lek 1946; 2: 141-2.
Powałowska J. Case of multifocal cutaneous leishmaniosis. Przegl Epidemiol 1978; 32: 261-4.
Dziubek Z, Horban A, Zarnowska H, et al. Cutaneous leishmaniasis among the cases of the Institute of Infectious and Parasitic Diseases, Medical Academy, in Warsaw. Wiad Parazytol 1988; 34: 663-4.
Zając-Marczewska M. Przypadek leiszmaniozy skórnej. XI Zjazd Polskiego Towarzystwa Epidemiologów i Lekarzy Chorób Zakaźnych, Puławy1988.
Skoryna-Karcz B, Chojecka-Adamska A, Adamski Z, Czep- czynski R. The case of cutaneous leishmaniosis – diagnostic difficulties. Przegl Dermatol 1994; 81: 544-7.
Skoryna-Karcz B. Evaluation of the epidemiological and clinical picture in diagnosis of cutaneous leishmaniasis. Postep Dermatol Alergol 1998; 15: 267-91.
Skoryna-Karcz B. Difficulties in diagnosis of cutaneous leishmaniasis cases. Probl Hig 2001; 73: 111-4.
Wojas-Pelc A, Brzeski M, Jaworek AK, et al. Leiszmanioza skórna – analiza przypadku klinicznego. XXVIII Zjazd Polskiego Towarzystwa Dermatologicznego, Bydgoszcz, 1-5 wrzesień 2004. Przegl Dermatol 2004; 91 (special issue): 41-2.
Paul M, Stefaniak J, Wasniowski A. Tropical skin diseases imported by travellers returning from equatorial Africa or Asia. Postep Dermatol Alergol 2007; 24: 16-25.
Pilarz Ł, Sikora A, Gębska E. Cutaneous leishmaniasis in Poland. Studium Vilnense A 2009; 6: 148-51.
Czepiel J, Biesiada G, Leśniak MR, et al. Cutaneous leishmaniasis in a patient returning from Morocco. Przegl Dermatol 2010; 97: 260-3.
Berkan E. Choroby tropikalne leczone w WSS im. W. Biegańskiego w Łodzi: leiszmanioza. Konferencja “Szczepienia ochronne dziś i jutro – medycyna podróży”, Łódź 2012.
Woźnica E, Ramos Ttito AP, Reich A. Leiszmanioza skórna. Forum Młodych Polskiego Towarzystwa Dermatologicznego XXVI Sympozjum Sekcji Alergologicznej Polskiego Towarzystwa Dermatologicznego. Przegl Dermatol 2014; 101: 359.
Olszański R, Siermontowski P, Juszczak D, et al. A case of cutaneous leishmaniasis treated with hyperbaric oxygen therapy. Pol Hyperbaric Res 2016; 57: 39-41.
Stefaniak J. Neglected tropical diseases u pacjentów leczo- nych w Ośrodku Poznańskim w latach 2000-2017. Jubileuszowa Konferencja Naukowo-Szkoleniowa “Zagadnienia wielodyscyplinarne medycyny podróży. Choroby tropikalne i pasożytnicze a zdrowie międzynarodowe”. 55 lat Katedry i Kliniki Chorób Tropikalnych i Pasożytniczych Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu, Poznań 2017.
de Wild M, Wiersma FH, Wolfs TF, van Hasselt PM. Cutaneous leishmaniasis in a Syrian refugee. Ned Tijdschr Geneeskd 2016; 160: D429.
Bradshaw S, Litvinov IV. Dermal leishmaniasis in a 25-year-old Syrian refugee. CMAJ 2017; 189: E1397.
Wollina U, Koch A, Guarneri C, et al. Cutaneous leishmaniasis – a case series from Dresden. Open Access Maced J Med Sci 2018; 6: 89-92.
Ready PD. Leishmaniasis emergence in Europe. Eurosurveillance 2010; 15: 29-39.
Poeppl W, Obwaller AG, Weiler M, et al. Emergence of sandflies (Phlebotominae) in Austria, a Central European country. Parasitol Res 2013; 112: 4231-7.
Wall EC, Watson J, Armstrong M, et al. Epidemiology of imported cutaneous leishmaniasis at the Hospital for Tropical Diseases, London, United Kingdom: use of polymerase chain reaction to identify the species. Am J Trop Med Hyg 2012; 86: 115-8.
Bart A, van Thiel PP, de Vries HJ, et al. Imported leishmaniasis in the Netherlands from 2005 to 2012: epidemiology, diagnostic techniques and sequence-based species typing from 195 patients. Euro Surveill 2013; 18: 20544.
Poeppl W, Oeser C, Grabmeier-Pfistershammer K, et al. Clinical findings and management of imported cutaneous leishmaniasis: report of 14 cases from Austria. Travel Med Infect Dis 2013; 11: 90-4.
Patel TA, Scadding GK, Phillips DE, Lockwood DN. Case report: old world mucosal leishmaniasis: report of five imported cases to the hospital for tropical diseases, London, United Kingdom. Am J Trop Med Hyg 2017; 97: 1116-9.
Lawn SD, Whetham J, Chiodini PL, et al. New world mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers. QJM 2004; 97: 781-8.
ITB World Travel Trends Report 2016/17. Messe Berlin GmbH, Berlin 2016.
Polish Tourism 2016/17 from the perspective of Polish Tour Operators Association. Polish Tour Operators Association, Warsaw 2017.
Report “Foreign vacation of Poles 2017”. Polish Chamber of Tourism, Warsaw 2017.
Jaremin B. Criteria and problems related to the diagnosis of malaria, amebiasis and leishmaniasis as occupational disease in Polish citizens. Przegl Epidemiol 1998; 52: 321-8.
Roberts T, Barratt J, Sandaradura I, et al. Molecular epidemiology of imported cases of leishmaniasis in Australia from 2008 to 2014. PLoS One 2015; 10: e0119212.
Kuna A, Gajewski M, Stańczak J. Evaluation of knowledge and use of the malaria prevention measures among the patients of the Department of Tropical and Parasitic Diseases University Center of Maritime and Tropical Medicine, Gdynia, based on a questionnaire performed in the years 2012-2013. Przegl Epidemiol 2017; 71: 33-44.
van Thiel PP, Leenstra T, de Vries HJ, et al. Cutaneous leishmaniasis (Leishmania major infection) in Dutch troops deployed in northern Afghanistan: epidemiology, clinical aspects, and treatment. Am J Trop Med Hyg 2010; 83: 1295-300.
Korzeniewski K, Olszański R. Leishmaniasis among soldiers of stabilization forces in Iraq. Review article. Int Marit Health 2004; 55: 155-63.
Korzeniewski K. Epidemiology of illnesses and injuries in specific climatic and sanitary conditions on the example of troops deployed to military operations. (Part one). Int Rev Armed Forces Med Serv 2013; 86: 43-57.
Bailey MS. Cutaneous leishmaniasis in British troops following jungle training in Belize. Travel Med Infect Dis 2011; 9: 253-4.
van Thiel PP, Zeegelaar JE, van Gool T, et al. Cutaneous leishmaniasis in three Dutch military cohorts following jungle training in Belize. Travel Med Infect Dis 2011; 9: 153-60.
Herwaldt BL. Leishmaniasis. Lancet 1999; 354: 1191-9.
Mulić R, Custović A, Ropac D, et al. Occurence of visceral and cutaneous leishmaniasis in Croatia. Mil Med 2009; 174: 206-11.
Campino L, Maia C. Epidemiology of leishmaniases in Portugal. Acta Med Port 2010; 23: 859-64.
Ntais P, Sifaki-Pistola D, Christodoulou V, et al. Leishmaniases in Greece. Am J Trop Med Hyg 2013; 89: 906-15.
Arce A, Estirado A, Ordobas M, et al. Re-emergence of leishmaniasis in Spain: community outbreak in Madrid, Spain, 2009 to 2012. Euro Surveill 2013; 18: 20546.
Ehehalt U, Schunk M, Jensenius M, et al. Leishmaniasis acquired by travellers to endemic regions in Europe: a EuroTravNet multi-centre study. Travel Med Infect Dis 2014; 12: 167-72.
Koliou MG, Antoniou Y, Antoniou M, et al. A cluster of four cases of cutaneous leishmaniasis by Leishmania donovani in Cyprus: a case series. J Med Case Rep 2014; 8: 354.
Giavedoni P, Iranzo P, Fuertes I, et al. Cutaneous leishmaniasis: 20 years’ experience in a Spanish tertiary care hospital. Actas Dermosifiliogr 2015; 106: 310-6.
Medenica S, Jovanović S, Dožić I, et al. Epidemiological surveillance of leishmaniasis in Montenegro, 1992-2013. Srp Arh Celok Lek 2015; 143: 707-11.
Ponrovsky EN, Strelkova MV, Zavoikin VD, et al. The epidemiological situation of leishmaniasis in the Russian Federation: the first valid cases of local transmission. Med Parazitol (Mosk) 2015; 3: 3-7.
Roth-Damas P, Sempere-Manuel M, Mialaret-Lahiguera A, et al. Community outbreak of cutaneous leishmaniasis in La Ribera region of Valencia, Spain: Public Health measures. Enferm Infecc Microbiol Clin 2017; 35: 338-43.
Marcoval J, Penín RM. Evolution of cutaneous leishmaniasis in the last 30 years in a tertiary hospital of the European Mediterranean coast. Int J Dermatol 2017; 56: 750-3.
Gaspari V, Ortalli M, Foschini MP, et al. New evidence of cutaneous leishmaniasis in north-eastern Italy. J Eur Acad Dermatol Venereol 2017; 31: 1534-40.
Rainova I, Harizanov R, Kaftandjiev I, et al. Human parasitic diseases in Bulgaria 2013-2014. Balkan Med J 2018; 35: 61-7.
Ahluwalia S, Lawn SD, Kanagalingam J, et al. Mucocutaneous leishmaniasis: an imported infection among travellers to central and South America. BMJ 2004; 329: 842-4.
Moreira OC, Yadon ZE, Cupolillo E. The applicability of real-time PCR in the diagnostic of cutaneous leishmaniasis and parasite quantification for clinical management: current status and perspectives. Acta Trop 2018; 184: 29-37.
Sagi O, Berkowitz A, Codish S, et al. Sensitive molecular diagnostics for cutaneous leishmaniasis. Open Forum Infect Dis 2017; 4: ofx037.
Tomasini C, Moneghini L, Barbui AM. Chronic amastigote-negative cutaneous leishmaniasis: a clinical, histopathologic and molecular study of 27 cases with emphasis on atypical and pseudolymphomatous presentations. J Cutan Pathol 2017; 44: 530-7.
Blum J, Buffet P, Visser L, et al. LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014. J Travel Med 2014; 21: 116-29.
Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and Treatment of Leishmaniasis: Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63: e202-64.
Gołąb E, Buczak-Stec E, Myjak P. Laboratory diagnostics of parasitic diseases in Poland and its costs. J Health Policy Insurance Manag – Polityka Zdrowotna 2013; 3: 69-78.
Availability and financing of laboratory diagnostics: post-audit report. Supreme Audit Office of Poland, Warsaw 2017.
Kurnatowski P, Moroz J. Otolaryngological manifestations of leishmaniosis. Otolaryngol Pol 2016; 70: 2-6.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe