“Aleppo Evil” قرحة حلب : The Ulcer, the Boil, the Sandfly, and the Conflict

Even in the best of times the Syrian Arab Republic (Syria) has struggled with cutaneous leishmaniasis (CL). We reported previously in PLOS Neglected Tropical Diseases that old world or anthroponotic CL caused by Leishmania tropica is endemic to Syria and elsewhere in the Middle East, North Africa, and Central Asia. In the ancient northern Syrian city of Aleppo CL has been present for hundreds of years (if not longer), where it is known as the “Aleppo Evil”, “Aleppo ulcer”, “Aleppo Boil”, or “Aleppo Button”. Aleppo evil is a disfiguring condition that disproportionately occurs on the face, especially of young people. It typically lasts one or two years before the lesion heals spontaneously, and is often known locally as “one-year sore”. However, in many cases specific anti-parasitic chemotherapy can hasten the healing process and improve clinical and cosmetic outcomes.

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