Fifteen-Year Evolution of Chronic Cutaneous Leishmaniasis Mimicking Other Dermatoses

Cutaneous leishmaniasis is an endemic parasitic infection in Colombia that typically presents as ulcerated skin lesions, although atypical variants can mimic diverse dermatosis leading to misdiagnosis and delayed treatment. We report the case of a 32-year-old woman with a 15-year history of progressive granulomatous and exophytic tumor-like plaques involving her lower face and neck. She was initially misdiagnosed with lymphocutaneous sporotrichosis and treated unsuccessfully with itraconazole for 1 year. The chronic facial involvement during her formative years resulted in major aesthetic and psychosocial consequences. Histopathology and direct smear ultimately confirmed Leishmania spp. infection. She received intramuscular meglumine antimoniate with marked clinical improvement. This case illustrates the diagnostic challenges of atypical chronic cutaneous leishmaniasis and emphasizes the need for thorough evaluation in endemic regions. Early recognition and appropriate management are essential to avoid therapeutic delays and long-term psychosocial impact.