Diagnostic and therapeutic challenges of cutaneous leishmaniasis in Canada: A case report.

Cutaneous leishmaniasis is increasingly reported in non-endemic areas due to international travel. This case describes a 17-year-old male from Western Canada who developed localized cutaneous leishmaniasis (Leishmania mexicana) after visiting the Yucatán Peninsula, Mexico. His persistent skin ulcers initially failed to respond to supportive wound care, thermotherapy, and systemic antimicrobials. Skin biopsy revealed granulomatous inflammation, and polymerase chain reaction confirmed L. mexicana species. Limited access to first-line treatments (e.g. miltefosine) in Canada complicated management. While intravenous liposomal amphotericin B provided partial improvement, complete healing occurred only after obtaining miltefosine. This case highlights the challenges of diagnosing and treating cutaneous leishmaniasis in non-endemic regions.