Clinical aspects of tegumentary leishmaniasis (TL) depend on the interaction between parasite virulence and the host
immune response, with lesions most frequently occurring in uncovered areas of the body. About 80% of the lesions are
located on upper and lower limbs. Genital lesions are rare. We followed up five patients with this presentation at the
outpatient clinic. Objective – Report the clinical and laboratory of five patients with genital lesions caused by Leishmania
braziliensis. Material and methods: Five cases of tegumentary leishmaniasis (TL) in the genital organs followed up at
the outpatient clinic, as part of a series of 350 cases between 2000 and 2005, were studied. The patients were submitted
to clinical-epidemiological assessment and exams (Montenegro skin test/MST, enzyme linked-immunosorbent assay/
ELISA and histophatology) for diagnostic. Treatment with N-methylglucamine antimonate (Glucantime®) at a dose of
15 to 17 mg/Sb+5/kg/day/20 to 30 days, with follow-up of 12 months after treatment. Results - Patient age ranged from
6 to 62 years (mean: 32.8). There was a predominance of males 4(80%). All patients were from TL risk areas (Florestal/
Jequié, Itagiba, Jaguaquara, São Gonçalo/Contendas do Sincorá, Bahia) and none had a history of TL. The duration
of the lesions until diagnosis ranged from 60 to 120 days (mean: 80). The most affected areas were the corpus of the
penis and glans. Ulcerated lesions and a clean or granular base in the absence of satellite lymphadenopathy were
observed in most cases (80%). The diagnosis was confirmed by leishmanin skin test positive (MST+/100%), Leishmaniareactive
ELISA (60%), and histopathology with amastigote of Leishmania in 5(100%). All patients were cured. Conclusions
- In our cases studied, only one patient had concomitant lesions but none of the patients had a history of TL, indicating
that the disease started by direct inoculation of the parasite into the affected area. Patient habits such as sleeping
naked and the lack of intradomiciliary sanitary installations support this hypothesis since they permit the exposure
of normally covered body areas. Another important aspect is the inclusion of genital lesions of TL in the differential
diagnosis of sexually transmitted and neoplastic diseases since its clinical can simulate diseases such as syphilis and
carcinoma. An early diagnosis facilitates adequate treatment and a favorable prognosis for the patients.
Key words: Tegumentary leishmaniasis, genital organs, genital ulcer, Leishmania braziliensis, state of Bahia, Brazil.