Cutaneous leishmaniasis (Kabul sore)
Cutaneous leishmaniasis, known in Afghanistan as saldana or Kabul sore, is a skin infection caused by a parasite spread by the bite of tiny sandflies. Kabul and other cities have many cases. It causes a slow-growing sore, often on the face, hands or legs, that can take months to heal and leave a lasting scar. It is not dangerous to life, but early treatment reduces scarring.
Symptoms
- A small red bump at the site of an insect bite, weeks or months later
- The bump slowly grows and becomes an open sore with a raised edge
- A crust or scab often covers the sore
- Usually painless unless it becomes infected
- One or several sores on uncovered skin such as the face, arms and legs
- Heals slowly and leaves a scar
Causes
- Leishmania parasites
- Bites of infected sandflies, which are active from dusk to dawn
- Sandflies breed in cracks of mud walls, rubbish and animal shelters
- Living in or visiting areas with many cases
Prevention
- Sleep under an insecticide-treated bed net
- Use fine screens on windows and doors
- Cover arms and legs in the evening and at night
- Use insect repellent
- Fill cracks in walls and keep rubbish away from the home
Treatment
- See a doctor to confirm the diagnosis, often with a small skin sample
- Small sores may be treated by freezing, heat treatment or injections into the sore
- Large or many sores may need injections into the muscle
- Treatment is available at leishmania treatment centres
- Keep the sore clean and covered
- Do not put acid, hot metal, kerosene or other home remedies on the sore; do not start prescription medicines without a doctor
Common questions
Is saldana contagious from person to person?
No. It does not spread by touching the sore or living with an infected person. It spreads only through the bite of an infected sandfly.
Will the sore heal without treatment?
Many sores heal by themselves after several months to a year, but they often leave a deep scar. Treatment can speed healing and reduce scarring, especially on the face.