Leishmania Recidiva Cutis in Morocco

In Morocco, leishmaniases are endemic diseases. Two forms of cutaneous leishmaniases are described: CL caused by Leishmania major and CL due to Leishmania tropica. These parasites are transmitted to humans by the bites of the infected female phlebotomine sandfly, a tiny, only 2–3 mm long insect vector.  L. major is transmitted by Phlebotomus papatasi from the animal reservoir to humans. L. tropica is transmitted by P. sergenti from person to person. The World Health Organization considers CL a severely neglected disease and a category 1 emerging and uncontrolled disease. Leishmaniasis recidiva cutis LRC is an unusual complication of acute CL. It consists of active lesions around or inside the scar of classical CL that apparently clinically healed. It appears after a variable period of time. Its prevalence increasing especially in immunocompromized  subjects. Diagnosis of LRC is often complicated by the scarcity of the microorganism in direct smear and tissue specimens. Actually, the management of CL and LRC is different from region to region and is mainly based on local expertise.  In this paper, we report two cases of recurrent CL in two women, two years after the complete healing of the primary lesions. On the basis of the available anamnestic data, the possible pathogenesis of LRC in this particular cases is also discussed.