Leishmaniosis cutánea en Costa Rica: epidemiología, retos en su diagnóstico y tratamiento: Cutaneous leishmaniasis in Costa Rica

Abstract

Cutaneous leishmaniasis (CL) is a parasitic disease endemic to Costa Rica transmitted by sandflies of the genus Lutzomyia and mainly caused by Leishmania panamensis. This study conducts a literature review analyzing the epidemiology, diagnostic challenges, and current therapeutic options, providing a context within Costa Rica. CL is widely distributed in rural areas, with higher incidence in Puntarenas, San José, Limón, and Alajuela. Its diagnosis presents significant challenges due to the clinical variability of skin lesions, the limitations of existing diagnostic tests, and the scarcity of methods that allow identification of the species involved. The first-line treatment is pentavalent antimony, although its effectiveness may vary depending on the species and the patient’s immune response. Miltefosine and liposomal amphotericin B are available alternatives, although they have limitations in efficacy, accessibility, or safety. In addition, the limited investment in research and development of new treatments and diagnostic methods is highlighted. This study concludes that an integrative approach to cutaneous leishmaniasis in Costa Rica requires strengthening early diagnosis, access to effective treatments, and promotion of clinical studies that improve the management and prevention of this neglected disease.