[Disseminated cutaneous leishmaniasis due to Leishmania viannia braziliensis in the state of Maranhão, Brazil].

The authors describe a case of a patient from Barreirinhas, MA with disseminated cutaneous leishmaniasis, who presented 58 lesions spread all over his body, with many different aspects, but ulcerative lesions were predominant. They discuss the difficulty of laboratory diagnosis in the beginning of the investigation and its therapeutics implications. The parasite isolated was identified as Leishmania viannia braziliensis using monoclonal antibodies in the fluorescent antibody test. This form of the disease is different from the diffuse cutaneous leishmaniasis found in Maranhão, due to Leishmania (Leishmania) amazonensis which is responsible for most of the cases of cutaneous leishmaniasis in our state. The possible mechanisms of lesions dissemination are discussed.