American cutaneous leishmaniasis (ACL) presents distinct active clinical forms with different grades of severity. known as localised (LCL). intermediate (ICL) and diffuse (DCL) cutaneous leishmaniasis. LCL and DCL are associated with a polarised T-helper (Th)1 and Th2 immune response. https://www.ensemblecarpediem.com/product-category/tattoos/