Assessment and treatment of cutaneous leishmaniasis in the emergency department

EVIDENCE AND PRACTICE Assessment and treatment of cutaneous leishmaniasis in the emergency department Stephen McGhee Associate Dean for Undergraduate Programs and Associate Professor of Clinical, School of Nursing & Health Studies, University of Miami, Coral Gables Florida, United States Neil Angus Senior Lecturer, University of the Highlands and Islands, Inverness, Scotland Alan Finnegan Professor of Mental Health, University of Chester, Chester, England LaToya Lewis-Pierre Assistant Professor of Clinical, School of Nursing & Health Studies, University of Miami, Coral Gables Florida, United States Johis Ortega Associate Dean, Hemispheric Programs, School of Nursing & Health Studies, University of Miami, Coral Gables Florida, United States Why you should read this article To understand how the Leishmania parasite is transmitted to humans To familiarise yourself with the patient groups who are most at risk of contracting cutaneous leishmaniasis To recognise how to prevent, diagnose and manage cutaneous leishmaniasis Cutaneous leishmaniasis is endemic in more than 70 countries worldwide. It is a non-fatal disease caused by the Leishmania parasite that is transmitted to humans via bites of infected female sandflies. Cutaneous leishmaniasis causes skin lesions on areas of exposed skin, such as the face and limbs, which often produce scarring and atrophy. If untreated, cutaneous leishmaniasis can develop into mucocutaneous leishmaniasis, which is potentially life-threatening. Furthermore, patients with cutaneous leishmaniasis commonly experience psychosocial issues such as anxiety, distress, stigma and rejection. Cutaneous leishmaniasis is spreading outside of its traditional endemic areas because of the effects of environmental changes such as urbanisation and climate change. In the UK, healthcare professionals may encounter the disease in migrants from endemic areas, members of the armed forces, tourists and expatriates. Therefore, emergency nurses need to be able to assess and support patients who present with symptoms suggestive of cutaneous leishmaniasis. This article provides an overview of the epidemiology, aetiology, pathophysiology, clinical presentation, diagnosis, treatment and prevention of the disease.