POLAR AND SUBPOLAR DIFFUSE CUTANEOUS LEISHMANIASIS IN BRAZIL: CLINICAL AND IMMUNOPATHOLOGIC ASPECTS

• DOI: 10.1111/j.1365-4362.1995.tb00613.x
• Publication Date: 2007-05-31T16:54:31Z
• Authors: ALDINA BARRAL; JACKSON M.L. COSTA; ACHILLA L. BITTEN...; M. BARRAL‐NETTO; EDGAR M. CARVALHO
• Keywords: Adult; Male; Adolescent; Biopsy; Leishmania mexicana; Leishmaniasis, Diffuse Cutaneous; Antibodies, Protozoan; Antigens, Protozoan; Immunohistochemistry; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Animals; Humans; Female; Child; Brazil; Skin Tests

Abstract Background. Diffuse cutaneous leishmaniasis (DCL) is a rare manifestation of human leishmaniasis, characterized by multiple, slowly progressive nodules or plaques without ulceration, involving almost the entire body. It has been suggested, that DCL results from lack cell‐mediated immunity to leishmanial antigen, leading uncontrolled parasite growth. Methods. We have performed detailed clinical, histopathologic, and immunologic investigations in six patients with DCL. Biopsies were taken nodules, processed, examined for determination macrophagic pattern present, based on intensity vacuolation frequency vacuolated cells, index, presence eosinophils. Immunologically, evaluated their response intradermal skin test PPD leishmania antileishmania antibodies immunofluorescent assay, lymphocyte proliferation assay. Results. There seemed be negative relation between ulcerations, whereas highest number parasites observed greatest macrophages. The delayed hypersensitivity antigen was negative, IgG positive all patients. Conclusions. Although cases fulfill criteria being classified as DCL, they present wide spectrum. Three clearly at unresponsive pole, three other belonged subpolar form exhibiting varying weak signs antiparasite responsiveness.