**Core Concept**
Visceral leishmaniasis, also known as kala-azar, is a systemic infection caused by Leishmania parasites that affects the reticuloendothelial system, including the spleen, liver, and bone marrow. Cutaneous manifestations are less common but can occur in response to the infection.

**Why the Correct Answer is Right**
Skin lesions in visceral leishmaniasis are often a result of the hypersensitivity reaction to the antigens released by the dying parasites. This reaction leads to the formation of non-caseating granulomas, which can manifest as skin lesions. The lesions are typically painless, firm, and erythematous papules or nodules that can appear anywhere on the body.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as skin lesions are not a primary feature of visceral leishmaniasis, which primarily affects the visceral organs.
**Option B:** This option is incorrect as it describes the skin lesions of cutaneous leishmaniasis, which is a different clinical entity.
**Option C:** This option is incorrect as it is a type of skin lesion associated with other conditions such as syphilis or yaws.

**Clinical Pearl / High-Yield Fact**
In visceral leishmaniasis, the skin lesions are often a delayed manifestation, typically appearing weeks to months after the onset of the disease.

**Correct Answer:** D.