RESUMO
The World Health Organization (WHO) has classified leishmaniasis as an uncontrolled and emerging disease. In Ecuador, the only anecdotal cases of diffuse cutaneous leishmaniasis were recorded in 1994 and have not been formally published. This form can be differentiated from classical localized cutaneous leishmaniasis by the number of injuries, the clinical type of the main elementary lesions (papular and acneform), and a weak response to standard treatments. The case we report is a 34-year-old woman who presented with disseminated nodular lesions and ulcers of various sizes with erythematous edges and scars. We report the case and review diffuse cutaneous leishmaniasis and the differences that can be found with the other cutaneous variants. The diagnosis requires to be considered by primary care physicians in endemic areas and specialists, taking into account that this presentation can also occur in immunocompetent hosts.