TNF and diffuse cutaneous Leishmaniasis: One important point to be addressed is that, as reported above [21,47,48], it has been described that L. (V. ) braziliensis tends to lead a T-cell hypersensitivity pole (strong production of IFNγ and TNFα) in patients with ML whereas L. (L.)amazonensis can lead to a T-cell hyposensitivity pole in patients with diffuse cutaneous leishmaniasis.