Oriental sore (acute cutaneous leishmaniasis) is usually a self-limited infection of the skin caused by the protozoan Leishmania tropica. This disease is endemic to the Mediterranean, Asia, Africa, and the Middle East, and is seen in this country among travellers and immigrants. We found four cases at the University of Michigan and diagnosed and treated the disorder. Some of the treatments currently recommended for this disease are potentially toxic, and none have been proved to be of real value. Uncomplicated, acute cutaneous leishmaniasis (L tropica) may best be managed by withholding treatment and observing the patient.