Journal Article

Failure of Early Treatment of Cutaneous Leishmaniasis in Preventing the Development of an Ulcer

Paulo Machado, Cibele Araújo, Andréa T. da Silva, Roque P. Almeida, Argemiro D'Oliveira, Achiléa Bittencourt and Edgar M. Carvalho

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 12, pages e69-e73
Published in print June 2002 | ISSN: 1058-4838
Published online June 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/340526
Failure of Early Treatment of Cutaneous Leishmaniasis in Preventing the Development of an Ulcer

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The clinical characteristics and treatment outcome were determined for 26 patients who presented with early-stage cutaneous leishmaniasis. Illness duration ranged from 8 to 20 days, and the commonest clinical presentation was the presence of a papule with small central crust on a lower extremity. Prominent regional adenopathy was found in 22 (85%) of 26 patients. The results of an intradermal skin test for Leishmania were positive for 96% of those patients, and results of serologic testing were positive for 61% of patients tested. Ten (46%) of 22 patients for whom follow-up data were available developed enlargement and ulceration of the lesion despite early antimony therapy and required additional courses of treatment. Histopathological studies of samples from the lesions of 3 patients showed vasculitis. These data show that early therapy for cutaneous leishmaniasis does not prevent the development of an ulcer in one-half of patients. This unfavorable outcome underlines the relevance of local exacerbated inflammatory and immune response in the pathogenesis of the disease.

Journal Article.  2532 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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