José Fabrício de Carvalho Leal, Caio César Bezerra Silva, Maria Beatriz Souza Nascimento, Renata Trindade Gonçalves, Lucia Helena Gomes Fernandes, Aridne Souza Costa Campos, Fellipe Magela de Araújo, Raimunda Nonata Ribeiro Sampaio, Daniel Holanda Barroso
Background/Objectives: American Tegumentary leishmaniasis typically presents as a single ulcerative lesion, but atypical clinical forms exist with diverse physiopathology and treatment responses. Disseminated cutaneous leishmaniasis is a less common presentation that is often challenging to treat and for which evidence-based clinical decisions are scant. A better understanding of treatment response may support the development of alternative therapeutic strategies. This study reports a retrospective cohort analysis using a time-to-event outcome to compare disseminated leishmaniasis with localized cutaneous leishmaniasis using a multivariate model. Methods: A total of 366 patients were screened for inclusion between 2014 and 2024, of whom 123 met the inclusion criteria. Results: After adjustment for age and sex, patients with disseminated cutaneous leishmaniasis had a significantly longer time to healing than those with localized cutaneous leishmaniasis (HR = 0.29; p = 0.021). Conclusions: Disseminated cutaneous leishmaniasis seems to be an important predictor of poorer clinical outcomes with prolonged healing time. New therapeutic strategies are urgently needed to address this issue.