History: This form of cutaneous Leishmaniasis begins as a slowly growing papule which evolves into a nodule which may break down into an ulcer.Most lesions spontaneously heal forming a scar but may take 6 months to do so.The condition is due to a bite from a sandfly Phlebotomus.In immunocompromised hosts the recidivans,sporotrichoid and mucocutaneous variants may occur.The diagnosis is made by examining smears of involved ulcers for organisms.