Cutaneous Leishmaniasis: a 46-year Study of the Epidemiology and Clinical Features in Saudi Arabia (1956-2002)

Objective: The aim of this study was to evaluate the epidemiology of cutaneous leishmaniasis in the Eastern Province of Saudi Arabia. In addition, the clinical spectrum of the disease was evaluated.

Methods: This is a retrospective study of cutaneous leishmania cases from 1956 to 2002.

Results: In the study period, there were 1862 patients with cutaneous leishmaniasis in the Saudi Aramco health care system. The disease is more prevalent in the Al-Hasa Oasis (Eastern Province of Saudi Arabia) and affects males and females equally. Cutaneous leishmaniasis follows a seasonal distribution in parallel with the known activity of the sandfly. The majority (76%) of cases occurred in patients < 15 years of age and the disease affected the extremities more frequently than the face. Seventy-one percent of patients presented with a single lesion and 27% presented with two lesions. Ulcerative cutaneous leishmaniasis was the predominant morphology (89%).

Conclusion: Cutaneous leishmaniasis attained epidemic proportions in 1973 and subsequently declined and reached a plateau in the mid-1980s. Skin involvement is the major clinical picture, with no evidence of dissemination or viscerotropic syndrome.