Specific Tissue Alteration in Leprous Skin

Tegumentary leishmaniasis and coinfections other than HIV

“…The search retrieved 12 case reports/series of human patients with concurrent leprosy and TL, but none of them contained evidence of a significant interaction between the two infections. Leprosy and TL are both caused by obligate intracellular organisms and involve a broad spectrum of clinical, histopathological, and immunological manifestations [ 6 , 70 , 73 – 83 ]. The paucibacillary/pauciparasitic type of disease (tuberculoid leprosy and localised cutaneous leishmaniasis) is at one pole of the spectrum and reflects effective T-cell immunity.…”

“…The paucibacillary/pauciparasitic type of disease (tuberculoid leprosy and localised cutaneous leishmaniasis) is at one pole of the spectrum and reflects effective T-cell immunity. At the other pole of the spectrum is the multibacillary/multiparasitic type of disease (lepromatous leprosy and diffuse cutaneous leishmaniasis), which occurs when the antigen-specific T-cell response is depressed [ 70 , 82 – 83 ].…”

“…In addition to these naturally occurring combinations of TL and leprosy, we found descriptions of artificially induced coinfection [ 83 , 84 ]. In the 1950s and 1960s, it was common practice in some Leishmania -endemic areas to immunise people against leishmaniasis by the inoculation of live Leishmania tropica parasites (‘leishmanisation’).…”

“…Twenty-three patients showed the classical clinical progression of cutaneous leishmaniasis at the site of inoculation. The authors suggested that this clinical response to vaccination was similar to that of people without leprosy [ 83 ]. One additional patient with lepromatous leprosy, described in a separate report, developed diffuse leishmaniasis after vaccination, but (also in this person) the lesions healed spontaneously.…”