Zosteriform cutaneous leishmaniasis

Dear Editor, We would like to discuss on the report on “Zosteriform cutaneous leishmaniasis” [1] Ramot et al. reported that “dermoscopy has proven to be an accessible and easy tool to diagnose such atypical presentation of cutaneous leishmaniasis, and dermatologists in endemic areas should be familiar with its typical dermoscopic features” [1]. In fact, cutaneous leishmaniasis is an important tropical dermatological infection. To diagnose it, the practitioner has to perform laboratory investigation to confirm the diagnosis [2]. The use of “in vivo confocal microscopy” is presently mentioned as a new noninvasive tool to diagnose cutaneous leishmaniasis [3,4]. As noted by Taheri et al., the appearance by dermoscopy of cutaneous leishmaniasis is varied [4]. The “paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid” appearance of cutaneous leishmaniasis is not common and can be easily missed. The limitation in diagnosis seems not due to limitation of the dermoscopy toll but the awareness of the practitioner on the disease, cutaneous leishmaniasis [5]. In endemic areas of cutaneous leishmaniasis, use of dermoscopy in the investigation of any cases of zosteriform cutaneous lesions to rule out cutaneous leishmaniasis is suggested.