Espundia (Synonym: Brazilian skin-mucous leishmaniasis). Skin and slimy American leishmaniasis has several nosological forms, the causative agents of which belong to the complex of L. Brasiliensis. The most severe form is Brazilian leishmaniasis (espuda), in which, in 80% of cases, in addition to ulcers on the skin at the site of the pathogen, there are also extensive lesions of the mucous membranes of the nasopharynx, larynx, and cartilage of soft tissues and even bones.