[Complex cutaneous Leishmaniasis from the "Old World" : Therapeutic challenges in two complicated disease courses]. / Komplexe kutane Leishmaniasis der Alten Welt : Therapeutische Herausforderungen bei 2 komplizierten Verläufen.

Here we describe two complicated cases of complex Old World cutaneous Leishmaniasis due to L. infantum and L. aethiopica. Both of our patients infected with the Leishmania parasite presented with a completely different clinical picture, course of disease, and treatment response. Clinical healing was achieved after multiple courses of treatment with a variety of different antileishmanial drugs. Nephrotoxity was a limiting side effect.

[A chronic wound from Vietnam]. / Eine chronische Wunde aus Vietnam.

Chronic skin lesions that occur in patients who have previously stayed in tropical countries pose a diagnostic challenge for physicians. In particular, if there is a granulomatous inflammatory reaction histologically, infectious diseases should also be included in the differential diagnosis. Particularly in persons returning from high-risk regions such as Vietnam, this includes cutaneous tuberculosis, which entails a thorough examination of the patient and comprehensive therapy. This case study shows which steps should be considered if cutaneous tuberculosis is suspected.

[Leprosy in Amazonas-impressions of the National Leprosy Program]. / Lepra in Amazonien ­ Eindrücke aus einem Kontrollprogramm.

Due to the often late detection and the neurological disability as a consequence of the disease, leprosy plays an important role in the public health system of emerging countries with the highest prevalence such as India and Brazil. The National Leprosy Control Program of the Ministry of Health and the Health Institutions of the Federal States in Brazil has implemented a strategy to ensure successful treatment of people in rural areas both at the preventive and curative level. A successful screening program, timely treatment of patients according to the stage of disease, and the introduction of preventive measures have significantly reduced the prevalence of leprosy in Brazil over the last 20 years. Due to limited medical care and socioeconomic weakness in the Amazon region in Brazil, the early eradication of leprosy does not seem to be currently realistic.