All of the lesions show:
(1) generalized erythema
(2) at least 1 vascular structure
An early lesion may show:
(1) papules
(2) yellow tears (yellow structures that are oval or teardrop shaped)
(3) vascular structures
Longstanding lesions may show:
(1) tumoral lesions with hyperkeratosis
(2) erosions/ulceration
(3) white starburst-like pattern (white halo at the periphery of the ulcer)
(4) vascular structures at the periphery
The most common vascular structures:
(1) comma-shaped
(2) linear, irregular
(3) dotted
(4) polymorphous
(5) hairpin
(6) arborizing telangiectasia
(7) glomerular-like
(8) corkscrew
The diagnosis can be confirmed by demonstrating the amastigotes (smear, biopsy, culture, PCR).
