Uncommon presentation of cutaneous leishmaniasis: late-onset facial involvement after a decade-a rare case report

Leishmaniasis is a parasitic infection that can involve the skin, mucosal membranes, and internal organs. It is endemic to the tropics. A forty-three-year-old male, diagnosed and treated for visceral leishmaniasis 15 years ago, presented with a complaint of a progressively growing lesion on his face for five years. A detailed history, clinical examination, and histopathological examination were done to reach a diagnosis of cutaneous leishmaniasis (CL). Treatment with oral fluconazole 300 mg daily for six months, followed by 50 mg miltefosine three times a day for another two months, led to complete resolution of symptoms, and the lesion on the face was cured. Early diagnosis is crucial to averting unwarranted treatment and potential complications. This case aims to inform clinicians of the high index of suspicion when diagnosing CL; given the delayed presentation, the previous medical history and the natural course of the lesion are of utmost importance.