Abstract: A 37-year-old man presented with rashes on the left lower limb with mild tenderness for 4 weeks. There were no systemic symptoms such as fever. The patient had worked as an aid worker in Iraq. Phyical examination showed 3 dark red plaques on the left leg, with a shallow ulcerated surface covered with pale yellow secretions in the center. Histological examination of lesions showed ulceration and scattered focal microabscesses with infiltration of lymphocytic cells and histiocytes, basophilic round bodies with diameters of 2-4 μm in histiocytes. Giemsa stain was positive. PCR analysis of the skin tissue indicated the L. major. Terbinafine was ineffective after 6 weeks of oral treatment, then fluconazole capsules were taken orally for 8 weeks and the lesions were cured. There were no serious adverse reactions during the treatment.

Key words: cutaneous leishmaniasis, L. major, fluconazole