Diffuse cutaneous leishmaniasis is a rare form of dermal infection, thus far found in Ethiopia and adjacent East Africa and in Central and South America.
Diffuse cutaneous leishmaniasis begins as a single skin nodule, which continues spreading until the entire body is covered by bizarre nodular lesions. These lesions, which resemble keloids or large verrucae, are frequently confused with the nodules of lepromatous leprosy.
The lesions do not ulcerate but contain vast aggregates of foamy macrophages stuffed with leishmania. Patients are usually immunologically unresponsive not only to leishmanin but also to other skin antigens, and the lesions often respond poorly to treatment.