Cutaneous leishmaniasis in a boy from Belize.

A 9-year-old boy from Belize presented with a 3-month history of enlarging plaques on his arm. Originating as papules, the lesions had progressed despite treatment with topical mupirocin, oral amoxicillin, and cephalexin. At presentation, physical examination revealed 2 well-circumscribed, round plaques with rolled borders and central erosion on the right forearm (Figure 1). A previous biopsy demonstrated amastigotes within histiocytes, consistent with a diagnosis of cutaneous leishmaniasis. Repeat biopsy sent for polymerase chain reaction, conducted by the Centers for Disease Control and Prevention (CDC), confirmed infection by Leishmania mexicana.