This article's uniqueness focuses on diagnosing Leishmaniasis, with particular attention to clinical manifestations and demographic factors when skin smear microscopy reveals a negative result and molecular tests are unavailable to the professional. The clinical case concerns an adult patient presenting a hyperkeratotic lesion in the right temporomalar region and another ulcerative lesion in the right atrial pavilion. A smear of the lesion was requested, resulting in a negative. However, two months later, new ulcerative lesions appeared, and a new smear was carried out with a positive result. Treatment with intramuscular Glucantime was started once daily for 21 days. When no improvement of ulcerated lesions in the temporomalar area and pinna was observed, the route of administration was modified by adding intralesional Glucantime, with evident improvement in the clinical state. It is relevant to consider that identifying demographic risk factors and the natural history of the lesions can be determining aspects for the diagnosis, even when the cytological study is negative. It is essential to ensure an adequate technique of taking the test to avoid false negatives and the correct administration of the chosen medication.
Keywords: Leishmaniasis; cutaneous, glucantime.