Cutaneous Old World leishmaniasis caused by Leishmania tropica in an Afghan woman. A, Initial presentation of the dry, plaque-like lesion with central nodule on the forearm. B, Intracellular parasites in vacuoles of a giant cell (arrowheads). Haematoxylin and eosin stain, magnification ×1,000. C, Leishmania in macrophages (arrowheads). Haematoxylin and eosin stain, magnification ×1,000. This figure appears in color at www.ajtmh.org.