Between 1986 and 1997 a total of 1418 patients were examined at the Clinical Analysis Teaching and Research Laboratory of Maringá State University (LEPAC/UEM) for cutaneous leishmaniasis by direct examination of stained smears made from the lesions, the Montenegro skin test and the indirect immunofluorescent antibody test. Nine hundred and fifty five patients (67.3%) were positive for at least one of the three tests and of these 804 (84.2%) were considered to have contracted the disease in Paraná State; 665 (69.6%) were between 15 and 49 years old; 658 (68.9%) were males; 523 (54.8%) sought medical advice during the first three months of their infections and 74 (7.7%) had mucosal lesions. Of the 83 counties of Paraná State, where the patients had most probably acquired their infections, 44.7% were from the counties of São Jorge do Ivaí (10.2%), Doutor Camargo (9.8%), Terra Boa (7.3%), Maringá (7.3%), Jussara (6.0%) and Cianorte (4.5%). Seventy seven strains of Leishmania (Viannia) braziliensis were isolated and 63.6% of these strains belong to serodema 1.

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Studies of topical treatments for leishmaniasis were systematically reviewed, to evaluate the therapeutic efficacy, safety and any adverse effects of these treatments. The papers identified in the databases PubMed and Web of Knowledge involved eight studies with a total of 1744 patients. The majority of trials was from Iran (4/8), covered a period of 8 years (2003-2011), and included patients 4-85 years of age. The most frequent Leishmania species in the studies were L. tropica (4/8) and L. major (2/8). The treatments administered were thermotherapy, paromomycin and combinations, CO2 laser, 5-aminolevulinic acid hydrochloride (10%) plus visible red light (633 nm) and cryotherapy. Six articles reported cure rates over 80·0%. Six studies reported on failure rates, three of them reporting rates lower than 10%. Four studies did not report relapses or recurrences, while the other studies reported low rates (1·8-6·3%). The most common adverse effects of the topical treatments were redness/erythema, pain, pruritus burning, oedema, vesicles and hyper- or hypopigmentation. The results provide strong evidence that the treatments topical evaluated showed high cure rates, safety and effectiveness, with low side-effects, relapse and recurrence rates, except for cryotherapy, which showed a moderate cure rate.

Sandflies of municipalities in North of Paraná State, South of Brazil-This work reports the results of sandfly collections in several places, during 2001 and 2002, in Bom Sucesso, Jardim Alegre, Kaloré, Londrina and Sabáudia municipalities, North of the State. The sandflies catches were performed with Shannon and Falcão traps in domiciliary areas, domestic animal shelters, barns and in the forest. A total of 4,019 specimens of 8 species were captured. Nyssomyia whitmani predominates in all of the municipalities. The species Migonemyia migonei, Nyssomyia neivai and N. whitmani may be involved in the epidemiology of American Tegumentary Leishmaniasis in this state.

The pharmaceutical industry has made great strides in providing drugs that are able to stimulate the healing process, but only 1–3% of all drugs that are listed in Western pharmacopoeias are intended for use on the skin or cutaneous wounds. Of these, at least one-third are obtained from plants. We sought to review the therapeutic effects of medicinal plants on human skin lesions. For this systematic review, we searched the PubMed, Scopus, and Web of Science databases to identify clinical trials that were published from 1997 to 2017. We reviewed studies that described the use of medicinal plants for the treatment of skin lesions in humans. Ten studies were selected, eight of which were published from 2007 to 2016, with a total of 503 patients. Among the plant species that were used for the treatment of human skin lesions, 12 belonged to 11 families and were included in the analysis. All of the plant species that were studied presented high therapeutic potential for the treatment of cutaneous lesions.

In the present study we investigated the role of platelet-activating factor (PAF) and prostaglandins in experimental Leishmania (Leishmania) amazonensis infection and the relationship between these mediators and nitric oxide (NO) production. Mouse peritoneal macrophages elicited with thioglicolate were infected with leishmania amastigotes, and the infection index determined 48 h later. The course of infection was monitored for 5 weeks in mice infected in the footpad with promastigotes by measuring the footpad swelling and parasite load in regional lymph nodes and spleen. The addition of PAF to C57BL/6 mouse macrophages significantly inhibited parasite growth and induced NO production. Treatment of macrophages with a selective PAF antagonist, WEB2086, increased the infection, indicating that endogenously produced PAF regulates macrophage ability to control leishmania infection. This effect of PAF was abolished by addition of the inhibitor of NO synthesis, L-NAME, to the cultures. The addition of prostaglandin E 2 significantly increased the infection and NO production. Treatment with cyclo-oxygenase inhibitor, indomethacin, reduced the infection and PAF-induced release of NO. Thus, the increased NO production induced by PAF seems to be mediated by prostaglandins. The more-selective inhibitors of cyclo-oxygenase 2, nimesulide and NS-398, had no significant effect. Thus, antileishmanial activity correlates better with the presence of PAF or absence of prostaglandins than with NO production. In vivo treatment with PAF antagonists significantly increased leishmania lesions, as well as the parasite load, in regional lymph nodes and spleens. These findings indicate that PAF is essential for the control of leishmania infection.Leishmania species have a worldwide distribution and can infect humans, causing a spectrum of diseases ranging from small cutaneous lesions to disseminated visceral leishmaniasis (11). Characteristically, Leishmania parasites multiply exclusively in the cells of the mononuclear phagocytic system (5). In murine resident macrophages, Leishmania parasites can survive within the phagolysosome and multiply extensively until lysing these cells (22). However, in activated macrophages, Leishmania parasites are promptly killed (32). Experimental infection with Leishmania parasites inducing cutaneous lesions in susceptible mice results in a disseminated and lethal infection, accompanied by an immune response dominated by CD4 ϩ T helper 2 (Th2) cells secreting interleukin 4 (IL-4), 36). In contrast, resistant strains of mouse which exhibit a self-limiting infection develop an immune response dominated by CD4 ϩ Th1 cells secreting gamma interferon (IFN-␥), IL-2, and tumor necrosis factor (TNF) (33). However, there are evidences that immunity to Leishmania is more complex and cannot be explained simply by the Th1-Th2 dichotomy (5, 43). It is well established in murine models that in cytokine-activated macrophages, the increased leishmanicidal activity correlates with increased NO (nitric oxide) production (15,...

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10,17,23,24 . Além disso, há evidências de que os flebotomíneos vêm encontrando nesses locais, ou nas suas proximidades, condições apropriadas para a procriação, devido à elevada densidade de insetos machos, que têm menor capacidade de dispersão 28 . O caráter endêmico da leishmaniose tegumentar no Norte do Paraná requer investigações sobre o comportamento dos flebotomíneos, em decorrên-