The disease has two common forms: * Cutaneous leishmaniasis, which is characterized by one or more large sores on the skin. It results when the parasite is generally limited to the skin's surface. * Visceral leishmaniasis, which is characterized by multiple organ failure. It results when the parasite enters the bloodstream. Among parasitic diseases, only malaria kills more people each year than leishmaniasis. About 500,000 people a year develop the disease, and 60,000 die from it.