皮肤利什曼病是一种被忽视的热带病，主要影响暴露的皮肤，在埃塞俄比亚引起严重和畸形性皮疹。在本报告中，我们介绍了两例非典型粘膜皮肤利什曼病的病例：一位HIV阳性患者和一位HIV阴性患者。病例：一位32岁的男性HIV患者出现了40天的直肠出血和5年的会阴病变。在右侧会阴区观察到一个长5厘米、宽5厘米的红斑性无痛斑块，并伴有直肠周围环形收缩性硬肿。经切片检查确诊为利什曼病后，患者接受AmBisome和米托膦酸治疗，最终治愈。一位40岁的患者出现了3个月的直肠出血和粪便失禁、2个月的全身水肿，以及肛门周围10年的肿块。肛门周围有一个长6厘米、宽3厘米的坚硬溃疡肿块和一个长8厘米的周围型肿块位于肛管上缘。经切除性切片检查确诊为利什曼病后，患者接受AmBisome治疗但因结肠造口后的腹泻并发症去世。结论：在像埃塞俄比亚这样的地区，医生应该考虑到非典型粘膜皮肤利什曼病可能是患有类似痔疮和结肠肿块的慢性皮疹的患者的可能诊断，无论其HIV状况如何。

Cutaneous leishmaniasis is a neglected tropical disease affecting mostly the exposed skin, causing severe and disfiguring lesions in Ethiopia. In this report, we present two cases of atypical mucocutaneous leishmaniasis; one HIV positive and one HIV negative patient. Cases. A 32-year-old male HIV patient presented with 40 days of bleeding per-rectum and a perianal lesion of 5 years. An erythematous nontender plaque measuring 5 cm by 5 cm was observed over the right perianal area with circumferential constricting firm swelling of the rectum. The patient was cured with AmBisome and miltefosine after an incisional biopsy revealed leishmaniasis. A 40-year-old presented with bleeding per-rectum and stool incontinence of 3 months, generalized body swelling of 2 months, and mass around his anus for ten years. A 6 by 3 cm indurated ulcerating mass surrounding the anus and a fungating circumferential mass of 8 cm were seen above the proximal anal verge. An excisional biopsy revealed leishmaniasis, and the patient was treated with AmBisome but passed away due to complications with colostomy diarrhea. Conclusion. Clinicians should consider atypical mucocutaneous leishmaniasis as a possible diagnosis in patients with chronic skin lesions resembling hemorrhoids and colorectal masses, especially in endemic areas such as Ethiopia, regardless of their HIV status.Copyright © 2023 Helina Fikre et al.