Dissemination in cutaneous leishmaniasis due to Leishmania major in different ethnic groups in Saudi Arabia

Background Dissemination in patients with cutaneous leishmaniasis has previ ously been recorded in human infection with Leishmania major and L. tropica . In this study, the potential for dissemination in different ethnic groups in Saudi Arabia was compared. Methods The data were recorded from a group of 73 patients with suspected c utaneous leishmaniasis (43 Saudi and 30 non-Saudi) attending the Dermatolog y Clinics at King Fahd Hospital of the University and Al-Khobar Government Hospital at Al-Khobar, Eastern Region of Saudi Arabia. The patients were of various age groups (all male) between 1 and 55 years. The diagnosis of cut aneous leishmaniasis was confirmed clinically and by smear and skin biopsy. The following data were recorded for each patient: type, number, and anato mic sites of disseminative lesions and the frequency of co-occurrence of mo re than one type of lesion. Results Three types of disseminative lesions due to zoonotic cutaneous leis hmaniasis were recorded in 16 patients (21.92%): subcutaneous nodules, sate llite papules, and subcutaneous induration. The percentage of disseminative lesions in non-Saudi patients (36.66%) was higher than in Saudi patients ( 11.63%). This was also true for the number of lesions: a mean of 12.27 +/- 10 and 6.4 +/- 3, respectively. The coexistence of more than one type of di sseminative lesion was higher in non-Saudi patients (63.63%) than in Saudi patients (20.0%), as well as the occurrence of lesions on more than one bod y site: 36.4% in non-Saudi patients and 20.0% in Saudi patients. Conclusions The potential for dissemination due to cutaneous leishmaniasis was significantly higher in the nonindigenous population than in the indige nous population in Saudi Arabia. Disseminative lesions must be clinically d ifferentiated from other skin diseases and appropriately treated by avoidin g the use of intralesional drugs or physical therapy.