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At present 90% of all mucocutaneous leishmaniasis occurs in Bolivia, Peru and Brazil. Illustrations of skin lesions and disfigurements suggestive of leishmaniasis are encountered on pre-Inca earthenware. These indicate that the disease was already in existence in Peru and Ecuador in the 1st century AD. Texts dating from the 15-16
th century Inca period and the Spanish conquest mention the risk of cutaneous ulcers in seasonal farmers. Espundia was also described as "white leprosy".
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Medicine Notes
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