Lupoid leishmaniasis is an unusual complication of acute cutaneous leishmaniasis which can represent a diagnostic and therapeutic challenge. The disease is actually a reactivation of an earlier acute cutaneous infection. It usually starts close to or in the scar of previous lesion and can cause severe destruction. Its diagnosis is complicated by the sparsity of the microorganisms in the direct smear and the tissue. The present report deals with a middle age Iranian woman presented to us with multiple scars on the whole face and also multiple red-down papules and nodules around these scars. After three years of clinical, histopathological and laboratory investigations and treating with no or minimal success for the diagnosed of discoid lupus erythematosus, sarcoidosis and lupus vulgaris, finally was diagnosed and treated successfully as lupoid leishmaniasis with meglumine antimoniate (Glucantime).