Unusual Presentations of Cutaneous Leishmaniasis in Two Iranian Patients

Leishmaniasis affects 1.5-2 million new cases in the world annually. Two major complications of cutaneous leishamaniasis include diffuse cutaneous leishamaniasis (DCL ) occurring in the setting of deficient cell mediated immunity, typically with HIV infection, and chronic cutaneous leishamaniasis (CCL ) developing in approximately 4% of L. tropica infections in Iran and Afghanistan which also may complicate vaccination with a live strain of leishmania (leishmanization). The Iran – Iraq war took place in a hyper endemic area of Old-World cutaneous leishmaniasis. We report two Iranian soldiers who were both infected in the battle field and presented several years after the war; one was an HIV positive patient with DCL and the other was a previously leishmaniazed patient with CCL.