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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science, Ltd
    International journal of dermatology 37 (1998), S. 0 
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Leishmaniasis recidiva cutis (LRC) is rare in New World leishmaniasis. Only seven cases have been reported so far.Materials and methods Four cases are reported here. Parasite diagnosis was performed by classical methods of touch preparations, histopathologic sections, and cultures. In addition, the detection of parasite DNA by the polymerase chain reaction (PCR) was performed in all cases.Results Parasites were detected by at least one of the classical methods in all primary lesions; however, only the PCR was positive in the recidivant lesions.Discussion LRC cases most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in scarred tissue. Although lupoid leishmaniasis (LL) has been used as a synonym of LRC, a clear difference between LRC and LL can be defined as LL is the initial clinical presentation while LRC is a recurrent lesion.Conclusions The results indicate that it is not appropriate to use these two denominations as synonyms. The designation of LRC should be maintained in order to define recidives occurring at the border of an old scar of cutaneous leishmaniasis, avoiding the confusion with the lupoid form of the disease.
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  • 2
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Rio de Janeiro State in Brazil is an endemic area of American tegumentary leishmaniasis (ATL) induced by Leishmania (Viannia) braziliensis. Objective Our purpose was to describe the main clinical and epidemiologic characteristics of the disease in Rio de Janeiro State. Methods Patients from endemic areas of Rio de Janeiro State attending the Evandro Chagas Hospital were included in the study. A general physical, dermatologic, and otorhinolaryngologic examination was performed in all patients, as well as a Leishmanin skin test. Skin biopsy specimens were obtained and utilized for touch preparations (stained with Leishman dye), culture in special media (Nicolle, Nevy and McNeal; NNN), and histopathologic examination after hematoxylin and eosin stain. Positive cultures were identified with regard to species by the isoenzyme technique. Therapy with pentavalent antimonial compounds was employed in all cases. Eco-epidemiologic characteristics were studied through regular field visits to endemic foci. Results Cutaneous disease was present in 87.2% of patients, and mucosal disease in only 12.7%. A single ulcerative cutaneous lesion was the most common clinical presentation. Demonstration of the parasite was always difficult and culture in special media gave the best results for diagnosis. The species involved in transmission was Leishmania (Viannia) braziliensis. Vectors included phlebotomine sand flies (Diptera: Psychodidae) of the genus Lutzomyia, and the most common species was Lutzomyia intermedia, captured mainly on the external walls of houses. Conclusions ATL in Rio de Janeiro is mostly a cutaneous disease. In general, the cases showed great sensitivity to antimony. A pattern of peridomestic transmission seems to be the rule.
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  • 3
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background The drug of choice for leishmaniasis is pentavalent antimony and different regimens are under continuous evaluation. The ideal therapy should be simple, effective, and with no or minor side-effects, in this paper we have studied the efficacy of intralesionally applied antimony in New World cutaneous leishmaniasis. Methods Seventy-four patients from Rio de Janeiro state, Brazil, and presenting with single ulcerative cutaneous lesions mainly located on the trunk or extremities were enrolled in the study. The drug employed was N-methyl glucamine (425 mg of Sbv in each 5 ml ampoule). Each lesion was infiltrated with the drug at the four cardinal points in order to achieve complete blanching. Results Of the 74 patients, 59 (80%) were healed after a 12–week interval. Extensive follow-up (up to 10 years) disclosed no relapses or the development of mucosal lesions. Conclusions The aim of therapy in New World cutaneous leishmaniasis is the healing of the cutaneous lesion and the prevention of late mucosal damage. Both conditions were achieved with the treatment employed with no side-effects and a considerable decrease in costs. In addition, the method is easy to apply in the field.
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  • 4
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Leprosy comprises a varied clinical spectrum that parallels cell-mediated immunity, the skin lesions of which are readily accessible for study6. Tuberculoid leprosy lesions contain relatively few organisms, and the host mounts a strong cell-mediated immune response which restricts growth of the ...
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