Cutaneous leishmaniasis: a neglected clinical manifestation among the tribal population in Nilambur, Kerala, India

Different clinical manifestations of leishmaniasis (cutaneous and visceral) caused by Leishmania donovani have been reported from Kerala, India. Leishmania donovani causing cutaneous leishmaniasis (CL) (also called atypical CL [ACL]) is one of the major health concerns in the Western Ghats belt of the state. Skin biopsies of 20 patients with suspected CL from Nilambur, Kerala, were processed for CL diagnosis during the period 2022-2023. Parasite species were characterized using Leishmania-specific Internal Transcribed Spacer-Ⅰ (ITS-Ⅰ) PCR and ITS-Ⅰ RFLP analysis. A total of 18 cases were confirmed to be CL and the parasite was identified as L. donovani. These indigenous ACL (CL due to L. donovani) reports from the small foci of Nilambur reveal an emerging endemic zone of leishmaniasis in the Western Ghats.