This often presents as a chronic "swimming-pool granuloma," which is a slow-growing nodule, unlike the more classic volcanic ulcer of leishmaniasis.
A nodulo-ulcerative BCC has a characteristic pearly, rolled border, which is absent in the heaped-up, granulomatous border of a leishmaniasis ulcer.
This is a painless, necrotizing ulcer caused by Mycobacterium ulcerans, distinguished by its significant undermining of the edges and lack of a granulomatous border.
A deep fungal ulcer is often diagnosed by culture and may have a more verrucous or crusted appearance than the typical "volcano" ulcer of leishmaniasis.
A persistent insect bite reaction can form a nodule, but it lacks the progressive ulceration and raised border of leishmaniasis; a history of travel to an endemic area is key.
An ulcerated SCC is characterized by a firm, indurated, and often keratotic border, unlike the softer, more granulomatous border of a leishmaniasis ulcer.
This is a painful, rapidly progressing ulcer with a necrotic base, often in a debilitated individual, lacking the more subacute, "volcano-like" appearance of leishmaniasis.
