Usefulness of ultrasound for treatment and follow-up of cutaneous leishmaniasis

Purpose Local therapy is the preferred option of treatment for most cutaneous leishmaniasis (CL); however, local therapy could be challenging, depth and size of the skin lesions are not always clinically evident and treatment response evaluation could occasionally be misleading. High frequency ultrasound is a non-invasive imaging tool which allows initial depth assessment ultrasound-guided infiltrations and ultrasound monitoring until resolution. Methods We present two cases of CL treated with ultrasound-guided infiltrations and ultrasound monitoring until resolution. Results Ultrasound imaging allowed a more accurate diagnosis of CL, defining more precisely the depth and size of the skin lesions. During follow-up, progressive decrease in dermal involvement, marked attenuation of the echogenicity of subcutaneous cellular tissue and a decrease in vascularization in the color Doppler mode was observed, which aided in evaluation of treatment response. Hypodermal inflammation observed through sonography was addressed with image-guided infiltration. Conclusion We would like to highlight the usefulness of skin ultrasound (both B-mode and color Doppler mode) in the diagnosis, depth assessment, imaging guided treatment, and follow-up in CL.