1. Infection with a Leishmania species associated with risk of mucosal leishmaniasis, mainly in Bolivia, Peru, and Brazil

2. >4 cutaneous lesions sized >1 cm

3. Cutaneous lesions sized ≥5 cm

4. Subcutaneous nodules

5. Enlarged regional lymph nodes (>1 cm)

6. Size or location of skin lesions making treatment difficult

7. Involvement of the face, fingers or toes, genitalia

8. Immunosuppression in the infected individual

9. Unsuccessful topical treatment after 2-3 months of treatment completion