American cutaneous leishmaniasis in Brazil.

Dear Editor,

the case report on "American cutaneous leishmaniasis in Brazil" deals with an interesting topic.[1] Bernardes Filho et al. reported on two new autochthonous cases of American cutaneous leishmaniasis in Brazil and state "the need for actions aiming at the early diagnosis and treatment of American cutaneous leishmaniasis cases.[1]" This report may add additional information to a recent report by Silva et al, which described an autochthonous case of cutaneous leishmaniasis in an urban center of Brazil.[2] These studies mention dogs as a reservoir host for leishmaniasis, and the human-animal interrelationship should be further investigated in epidemiological surveillance studies.[3] In fact, re-emergence or new emergence of American cutaneous leishmaniasis is an important concern in tropical dermatology. This disease can be difficult to diagnose if the general practitioner does not recognize it. The dermatological appearance of the disease can sometimes be uncommon (e.g., it may present as a zosteriform lesion) and this may lead to delayed diagnosis.[4] A successful management of the disease can be expected if early diagnosis is achieved. Some new drugs (such as paromomycin) are effective for treatment of cutaneous leishmaniasis.[5]