Multiple ulcerated skin lesions simulating leishmaniasis: a challenge in differential diagnosis

Abstract

Introduction: Multiple ulcerated skin lesions represent a diagnostic challenge, especially because they mimic cutaneous leishmaniasis. This disease, caused by protozoa of the genus Leishmania, is endemic in several regions and can be confused with other pathologies such as mycoses, leprosy and neoplasms. Clinical diagnosis is often flawed, making laboratory tests essential for correct identification. In addition to the impact on public health, inaccurate diagnosis can lead to inadequate treatment and antimicrobial resistance. Methodology: An integrative literature review was carried out to identify evidence-based practices, using the PICo strategy. Articles published between 2020 and 2025 were analyzed, selected from databases such as LILACS, SciELO, PubMed and Scopus. After rigorous screening, 10 studies were included in the review. The study did not involve clinical research with humans or animals. Results and Discussion: The findings highlight the difficulty of differential diagnosis, as several dermatological conditions share characteristics with leishmaniasis. Methods such as histopathology and PCR demonstrate high specificity, reducing diagnostic errors. The epidemiological context and the training of health professionals directly influence diagnostic accuracy. In addition, unequal access to laboratory tests compromises early detection and proper case management. Conclusion: Diagnostic accuracy is essential to avoid inadequate treatment and complications. The adoption of advanced laboratory tests, professional training and public policies that increase access to diagnostics are fundamental to improving the management of multiple ulcer lesions.