Transepidermal elimination in cutaneous leishmaniasis: a multiregional study

Abstract

We report the largest multiregional cutaneous leishmaniasis series with a 28.3% documented transepidermal elimination incidence of which 48% were perforating plug; a significant prevalence of L. major was also identified in the transepidermal elimination group. The association of transepidermal elimination with interface changes and a higher parasitic index, without an increased ulceration rate, may reflect a unique biologic alteration in the epidermis, serving to facilitate the extrusion of the parasites through the skin.

The immune microenvironment in cutaneous leishmaniasis

“…Note that the CD1a cross‐reactivity identified in leishmania amastigotes within Langerhans cells appears to be antibody clone specific with reactivity against clone MTB1 as opposed to clone 010; the absence of promastigote staining implies that the amastigotes internalized the receptor protein homology of clone MTB1. Intracytoplasmic CD1a expression by leishmania amastigotes was observed in most of the current case series corroborating the results by Karram et al …”

“…Decreased CD1a receptor expression has also been documented with chronic Leishmania tropica and L. braziliensis guyanensis infection . Furthermore, leishmania amastigotes located intracytoplasmically within macrophages and Langerhans cells, expressed CD1a . The major inflammatory cell populations in CL were reported to consist of T cells (CD4:CD8 ratio of ~1.05), macrophages, a minute B‐cell fraction, natural killer cells and granulocytes .…”

First detection of Leishmania kDNA in canine cerumen samples by qPCR

“…This phenomenon has been described for Leishmania parasites in all epidermal layers, hair follicles and eccrine sweat glands (Perrin et al, 1995;Espinel et al, 2004;Karram et al, 2012). However, it cannot be excluded the incorporation of Leishmania kDNA to cerumen by migration from the bloodstream, because ear and the ear canal itself receive blood from a high number of arteries (Steven-Sparks, 2012).…”

Multiple ulcerated lesions in a child

“…Antibody to CD1a, a protein expressed by certain dendritic cells, is also positive in amastigotes. There are two theories proposed regarding this immunophenotype: amastigotes somehow acquire CD1a during the process of exocytosis from dendritic cells, or the less‐favored theory proposes cross‐reactivity with CD1a antibody. The CD1a staining pattern is that of a peripherally stained kinetoplast and an uninvolved nucleus of the amastigote.…”