Do you routinely refer all patients with cutaneous leishmaniasis with a species associated with mucocutaneous leishmaniasis to ENT for comprehensive nasal/oropharyngeal evaluation, or do you refer only if mucocutaneous involvement is suspected based on careful clinical assessment and/or bedside exam?

Yes. Mucocutaneous leishmaniasis-associated Leishmania/Viannia species can involve any part of the oropharynx. This is often difficult to identify and often requires molecular testing. If molecular or culture testing of a skin lesion shows a Viannia species I would also do an oral exam via ENT. If t...