Painless Ulcers After a Long Journey

A 3-year-old boy develops painless ulcers and bumps on his leg after immigrating from Venezuela. What is the diagnosis for these persistent Skin Lesions?

Cutaneous Leishmaniasis


A previously healthy 3-year-old boy was brought to the emergency department with a 6-week history of painless bumps and ulcers on his left leg. He initially had itchy insect bites on his foot and then bumps and ulcers had developed slowly on his leg. The boy had recently immigrated from Venezuela after a months-long journey by land with his family. On physical examination, ulcerated plaques with rolled borders and satellite papules were observed on the left lower leg, buttocks, and back. Three biopsy samples were obtained from one of the lesions. Histopathological analysis was notable for severe lymphohistiocytic infiltration with no organisms identified by routine microbiologic stains. What is the most likely diagnosis?

What is the most likely diagnosis?

Brown recluse spider bites
Cutaneous Leishmaniasis
Leprosy
Phaeohyphomycosis
Pyoderma gangrenosum

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