Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/32109
Title: Polar and subpolar diffuse Cutaneous Leishmaniasis in Brazil: clinical and immunopathological aspects
Authors: Barral, Aldina Maria Prado
Costa, Jackson Mauricio Lopes
Bittencourt, Achiléa Candida Lisboa
Barral Netto, Manoel
Carvalho, Edgar Marcelino de
Affilliation: Universidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil.
Federal University of Maranhão. Faculty of Medicine. Department of Infectious and Parasitic Diseases. São Luís, MA, Brazil.
Universidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil.
Universidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil.
Universidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil.
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 a lack of cell-mediated immunity to leishmanial antigen, leading to uncontrolled parasite growth. Methods. We have performed detailed clinical, histopathologic, and immunologic investigations in six patients with DCL. Biopsies were taken from the nodules, processed, and examined for determination of the macrophagic pattern present, based on the intensity of vacuolation and the frequency of vacuolated cells, the parasite index, and the presence of eosinophils. Immunologically, patients were evaluated by their response to intradermal skin test to PPD or leishmania antigen, determination of antileishmania antibodies by immunofluorescent assay, and lymphocyte proliferation assay. Results. There seemed to be a negative relation between nodules and skin ulcerations, whereas the highest number of parasites were observed in patients with the greatest number of vacuolated macrophages. The delayed hypersensitivity skin test to leishmanial antigen was negative, and antileishmania IgG antibodies were positive in all patients. Conclusions. Although all cases fulfill the criteria for being classified as DCL, they present a wide spectrum. Three cases were clearly at the unresponsive pole, and three other cases belonged to the subpolar form of DCL, exhibiting varying weak signs of antiparasite responsiveness.
Keywords: Cutaneous leishmaniasis
Leishmaniasis
Immunity
Clinical study
Macrophages
Humans
keywords: Leishmaniose cutânea
Leishmania
Imunidade
Estudo clinico
Macrofagos
Humanos
Issue Date: 1995
Publisher: Wiley
Citation: BARRAL, A.M. P. et al. Polar and subpolar diffuse Cutaneous Leishmaniasis in Brazil: clinical and immunopathologic aspects. International Journal of Dermatology, v. 34, n. 7, p. 474-479, 1995.
Description: Manoel Barral Neto; Barral, Aldina Maria Prado. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento.
ISSN: 0011-9059
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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