A 31-year-old diamond miner with chronic and relapsing skin ulcers. What is the diagnosis?

Abstract

A previously healthy-31-year-old man presented in September 2007 to his doctor with a recurrence of painless ulcers on his left leg. He had traveled into Angola over 10 years for work involving diamond alluvial mining. He stayed mainly in the diamond province of Lunda Note, in an area called Capemba Camulembe. He was exposed to fresh water while working on the open mines on the banks of the rivers as well as while swimming, bathing or taking a shower in the tributaries of the Cuango River. During this time he frequently experienced cuts/abrasions of his skin. In ten years he had been treated for malaria three times.