An epidemiologic study of American cutaneous leishmaniasis in Maipuco, Peru.

Two forms of leishmaniasis occur in Peru. One, known as uta, occurs in the western valleys of the Andes and produces a cutaneous lesion of spontaneous remission that rarely causes contiguous mucosal damage. The other, called espundiu, occurs in the Amazon region and produces cutaneous lesions that in some cases are indistinguishable from those of utu. However, it can also produce destructive metastatic mucosal lesions, typically in the nasal septum or the oropharyngeal mucosa c-1,2). Little is known about the epidemiology of the two forms, particularly in the Amazon region, or about the natural history, distribution, reservoirs, transmission mechanisms, and pathogenic agents of the disease in these areas. Furthermore, an indeterminate number of cases go unreported every year in Peru, largely because of the sociocultural circumstances of the affected populations. Nevertheless, endemic areas are recognized within the country; and the focal behavior of the