Leishmaniasis recidiva cutis in New World cutaneous leishmaniasis

Oliveira-Neto, Manoel P.; Mattos, Marise; Silva, Celeste da; Souza, Freitas de; Fernandes, Octávio; Pirmez, Claude

doi:10.1046/j.1365-4362.1998.00478.x

Cited by 47 publications

(37 citation statements)

References 13 publications

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“…Characteristic papular and vesicular lesions appear after clinical cure in or around the scar of the healed sore after a variable period of time from months to years. Most of the identified parasites in the New World were of the subgenus Viannia [14], but L. (L.) amazonensis in Brazil [15] and L. (V.) panamensis in Ecuador [16] were also observed.…”

Section: Leishmaniasis Recidiva Cutismentioning

confidence: 99%

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Goto¹,

Lindoso

2010

Expert Review of Anti-infective Therapy

389

388

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Section: Leishmaniasis Recidiva Cutismentioning

confidence: 99%

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Goto¹,

Lindoso

2010

Expert Review of Anti-infective Therapy

389

388

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“…We emphasized the application of PCR to chronic lesions because these patients provided the greatest diagnostic challenge. Chronic lesions are easily misdiagnosed by clinical criteria because they are often atypical, giving rise to terms such as carcinoma-like, lupoid, sporotrichoid, and verrucoid leishmaniasis (9,23,42). Moreover, due to the low density of Leishmania in chronic disease, conventional laboratory methods are much less sensitive in detecting the protozoans in lesions of more than 6 months' duration (38).…”

mentioning

confidence: 99%

PCR-Based Diagnosis of Acute and Chronic Cutaneous Leishmaniasis Caused by Leishmania ( Viannia )

et al. 2002

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We evaluated PCR methods for diagnosis of acute and chronic cutaneous leishmaniasis (CL) in an area of Colombia where Leishmania (Viannia) is endemic. The PCR method specifically amplified whole linearized minicircle kinetoplast DNA (kDNA) of the Leishmania subgenus Viannia from biopsy lysates. PCR products were detected in agarose gels. For 255 acute cases, this PCR method had greater sensitivity (75.7%) than each conventional method, i.e., microscopic examination of Giemsa-stained lesion scraping (46.7%), biopsy culture (55.3%), aspirate culture (46.3%), and the conventional methods combined (70.2%). Among 44 cases of chronic CL, amplification of biopsy DNA was more sensitive (45.5%) than the individual (4.5 to 27.7%) and combined (27.3%) conventional methods. The detection of kDNA in biopsies from chronic lesions was enhanced by a chemiluminescent dot blot hybridization, which produced a sensitivity of 65.8% when alone and 90.9% when in combination with DNA extraction of biopsy lysates (P < 0.001). Three biopsies from 84 skin lesions of other etiologies were falsely positive by PCR (specificity, 96.4%). PCR detected kDNA more frequently in biopsies (detection level, 83.9%) than in aspirates (74.7%) from 103 cases of acute CL. Among aspirates from 53 chronic cases of CL, the alternative methods, DNA extraction and hybridization, increased sensitivity from 41.5 to 56.6% (P > 0.05). This enhanced PCR method in chronic biopsies was so much more sensitive than conventional methods that it should be considered the preferred diagnostic method for chronic CL. These findings support the appropriate incorporation of PCR into diagnostic strategies for cutaneous leishmaniasis.The leishmaniases are a group of illnesses of the skin, oral and respiratory mucosae and the reticuloendothelium caused by protozoa of the genus Leishmania. Of these, the cutaneous form is the most widespread, afflicting primarily rural and periurban populations exposed to the infected sand fly vector. Cutaneous leishmaniasis (CL) is most frequently diagnosed by clinical evaluation, either alone or in combination with the leishmanin skin test. Clinical evaluation usually suffers from lack of standardization (13,38) and is hampered by the fact that even fairly typical acute lesions can be confused with other dermatological problems, such as sporotrichosis (9). The leishmanin skin test is highly sensitive but lacks specificity when employed in areas of endemicity because it cannot distinguish acute lesions from past infection. A definitive, laboratory diagnosis of mucosal or cutaneous leishmaniasis traditionally requires either the visualization of amastigotes or the isolation of replicative Leishmania from lesions (24). The most widely employed laboratory methods for CL are microscopic examination of lesion scrapings, biopsy impression smears, and histopathology. The most sensitive conventional diagnostic methods, culture of lesion biopsies and aspirates, are available only in reference laboratories. Even these less available, more sensitive methods ...

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“…Lesions of LR most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in the scarred tissue [15].…”

Section: Discussionmentioning

confidence: 99%

“…It is also known as leishmaniasis recidiva cutis (LRC) in the New World. Few patients have been reported from the New World; L. braziliensis subspecies, L. amazonensis, L. panamensis, and L. guyanensis have been isolated from patients in Brazil, Colombia, and Guyana [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

Dassoni

Daba

Naafs³

et al. 2017

J Infect Dev Ctries

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Cutaneous leishmaniasis (CL) is endemic in Ethiopia. An unusual clinical form of this disease is leishmaniasis recidivans (LR), a prolonged, relapsing form of cutaneous leishmaniasis resembling tuberculosis of the skin that may persist for many years with a chronic and relapsing course. This rare variant has been shown to be caused by Leishmania tropica species in the Old World and by Leishmania braziliensis, Leishmania amazonensis, Leishmania panamensis, and Leishmania guyanensis in the New World, as reported in various studies. To our knowledge, there are no reports from Ethiopia, and mucocutaneous involvement of LR has not been described to date. This was a retrospective analysis of the patients seen at the Italian Dermatological Center in Mekelle on the Tigrean highlands over a threeyear period (2008)(2009)(2010)(2011). Seven patients with typical clinical features of LR were seen. Two of them presented with signs of mucosal involvement. To date, Leishmania aethiopica is shown to be the only species causing CL that is endemic in the Ethiopian highlands. Therefore, it had to be assumed that the lesions in these patients were caused by this species. The aims of this communication are to report, for the first time, the presence of LR, most likely due to Leishmania aethiopica, in Ethiopia, and to report mucosal involvement in this rare clinical form of CL.

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Leishmaniasis recidiva cutis in New World cutaneous leishmaniasis

Cited by 47 publications

References 13 publications

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

PCR-Based Diagnosis of Acute and Chronic Cutaneous Leishmaniasis Caused by Leishmania ( Viannia )

Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

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