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Leishmaniasis, Cutaneous parasitology treatment response HIV Infections antihistaminic agent Human immunodeficiency virus infection arm disease complication papule leg pain human immunocompromised patient travel antibiotic agent migrant crisis thrush miltefosine forearm nodule antiretrovirus agent Note Somali (citizen) Central America nonhuman Minnesota ethnology asylum seeker Humans migrant weight reduction male dermatology case report social problem South America punishment leg ulcer clinical article legislation and jurisprudence adult migration Somalia nose obstruction molecular diagnosis Emigration and Immigration Leishmaniasis, Mucocutaneous skin leishmaniasis persecution patient preference Leishmania braziliensis Fear Fatigue