I would walk 1000 miles: A case of cutaneous leishmaniasis at a safety net hospital

A case of cutaneous leishmaniasis (CL) was identified in Dallas, Texas, an area where CL is rarely encountered. The patient presented with chronic ulcerative skin lesions, prompting histopathological evaluation and molecular testing. Diagnosis was confirmed by identification of Leishmania organisms on biopsy and PCR-based speciation. This case underscores the diagnostic challenges of CL in nonendemic regions, where clinical suspicion may be low and routine histopathology can be pivotal. The occurrence of CL in Texas highlights the potential for autochthonous transmission and the need for heightened awareness among clinicians, especially given the expanding geographic range of sand fly vectors and increased international travel. Early recognition and species identification are essential for guiding therapy and preventing complications. This report contributes to the growing literature on CL in North America and emphasizes the importance of considering leishmaniasis in the differential diagnosis of chronic, nonhealing cutaneous lesions.