skip to main content

Local CL Treatment L. mexicana — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateTropical & Imported InfectionsLocal CL Treatment L. mexicanaSCE Infectious Diseases

A 50-year-old man from Central America presents with a chronic ulcerating skin lesion on his arm. Biopsy shows organisms within macrophages. Leishmania PCR identifies L. mexicana complex. The lesion is solitary, 2 cm, on the forearm, with no mucosal involvement. What is the most cost-effective treatment approach?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Local therapy (cryotherapy with liquid nitrogen, or intralesional Sodium Stibogluconate) — L. mexicana rarely causes mucocutaneous disease; local treatment is appropriate for single small lesions

For single small cutaneous leishmaniasis lesions caused by L. mexicana complex (low risk of mucocutaneous dissemination), local therapy is preferred over systemic treatment due to: lower cost, fewer side effects, and comparable efficacy. Cryotherapy (liquid nitrogen, 2 cycles of 15–20 seconds, repeated weekly for 3–4 sessions) or intralesional sodium stibogluconate are standard local options. Systemic therapy (Liposomal Amphotericin B, Miltefosine) is reserved for: L. braziliensis (high mucocutaneous risk), multiple/large lesions, immunocompromised patients, or failure of local therapy.

Reference: WHO 2022 – Leishmaniasis; LSTMH/BSAC 2019 – UK leishmaniasis guidelines