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At least 37 records · Page 2Linked to original sources
PubMed1984

Monocyte suppression of antigen-specific lymphocyte responses in diffuse cutaneous leishmaniasis patients from the Dominican Republic.

Patients from the Dominican Republic with diffuse cutaneous leishmaniasis showed in vivo and in vitro anergy to leishmanial antigen. Relatives of these DCL patients living in the same endemic area frequently showed skin test and lymphocyte reactivity to leishmanial antigens. This further supports the concept of specific anergy in patients with diffuse cutaneous leishmaniasis. Adherent suppressor cells modulate the antigen-specific lymphocyte proliferative response. Suppressor cells could also be isolated by Percoll gradient centrifugation. Co-culturing of lymphocytes and monocytes from HLA-identical leishmanin responders and nonresponders also identified the suppressor cell as a monocyte. In one patient, this suppression disappeared when clinical cure had been accomplished.

Adolescent↗
PubMed1989

Diffuse cutaneous leishmaniasis in Mexico.

In Mexico, 6 cases of diffuse cutaneous leishmaniasis (DCL) were found in widely separated geographic regions. Information was also available on 2 other cases. In addition to the typical clinical features, half of the patients had evidence of nasopharyngeal mucosal involvement. All isolates from the DCL patients were identified as Leishmania mexicana mexicana by isoenzyme analysis and monoclonal antibody typing. In 1 region of Tabasco state where DCL was found, uncomplicated cutaneous leishmaniasis appeared to be highly endemic, and isolates from a few such patients were identified as L. mexicana mexicana. An incidental finding was the recovery of an isolate of L. braziliensis braziliensis from a patient with chiclero ulcer in Oaxaca state. The clinical and epidemiological significance of the reported cases are discussed.

Adolescent↗
PubMedDate not supplied

Diabetes mellitus associated with pentamidine isethionate in diffuse cutaneous leishmaniasis.

The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL), for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceration. He used pentavalent antimonial (glucantime) and an association of gamma interferon plus glucantime with improvement of the lesions but relapsed later. Recently, pentamidine isethionate (pentacarinat) was given a dosage of 4mg/kg/weight/day on alternate days for 20 applications. After 3 months a similar course of 10 application was given 2 times. Later he developed diabetic signs with weight loss of 10kg, polydypsia, polyuria and xerostomia. The lower limbs lesions showed signs of activity. Blood glucose levels normalised and remain like this at moment. Attention is drawn to the fact that pentamidine isethionate should be used as a therapy option with care, obeying rigorous laboratory controls including a glucose tolerance test.

Adult↗
PubMedDate not supplied

Antigenic differences of Leishmania amazonensis isolates causing diffuse cutaneous leishmaniasis.

Six geographically distinct isolates of Leishmania amazonensis causing diffuse cutaneous leishmaniasis (DCL) (from Bahia and Maranhão, in Brazil and Guarico, in Venezuela) were characterized by immunoblot analysis to see whether any geographical or strain-related differences existed in antigenic composition. Western blots of promastigote homogenates were reacted with polyclonal sera from patients infected with L. amazonensis with the various forms of clinical disease. The pattern of antigenic reactivity of these strains revealed the presence of shared antigenic components between geographically distinct L. amazonensis isolates causing DCL, when tested with the sera of the infected patients. In certain cases, however, some polyclonal sera also detected antigenic fractions unique to the strains examined. Variation was observed between the antigenic components of some isolates of L. amazonensis that were recognized by a single serum, and between the antigenic components of a single isolate of L. amazonensis that were recognized by the different patients' sera. However, no constant association was found between the antigenic components identified in these isolates and the geographical area of isolation. These results indicate that, although these parasites appear to be closely related antigenically, they also possess some strain-related antigenic differences.

Animals↗
PubMed1999

Treatment of two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana modifies the immunohistological profile but not the disease outcome.

Two patients with diffuse cutaneous leishmaniasis caused by Leishmania mexicana were treated with two leishmanicidal drugs (pentamidine and allopurinol) combined with recombinant interferon-gamma restoring Th-1 favouring conditions in the patients. Parasites decreased dramatically in the lesions and macrophages diminished concomitantly, while IL-12-producing Langerhans cells and interferon-gamma- producing NK and CD8 + lymphocytes increased in a reciprocal manner. The CD4+/CD8 + ratio in the peripheral blood normalized. During exogenous administration of interferon-gamma the parasites' capacity to inhibit the oxidative burst of the patients' monocytes was abolished. Even though Th-1-favouring conditions were restored, both patients relapsed two months after therapy was discontinued. We conclude that the tendency to develop a disease-promoting Th-2 response in DCL patients is unaffected by, and independent of, parasite numbers. Even though intensive treatment in DCL patients induced Th-1 disease restricting conditions, the disease-promoting immunomodulation of few persistent Leishmania sufficed to revert the immune response.

Allopurinol↗
PubMedDate not supplied

Co-infection by Leishmania amazonensis and L. infantum/L. chagasi in a case of diffuse cutaneous leishmaniasis in Bolivia.

We present the first report of a co-infection by Leishmania amazonensis and L. infantum/L. chagasi isolated in 1993 from a patient with diffuse cutaneous leishmaniasis (DCL), living in the sub-Andean region of Bolivia. This is the third reported case of DCL in Bolivia, but the first one with isoenzymatic identification of the aetiological agents involved and the first one giving evidence for a mixed infection by 2 Leishmania parasites in the same lesion.

Animals↗
PubMed1993

Diffuse cutaneous leishmaniasis in a cat.

An adult long-haired domestic cat native to South Texas developed signs consistent with diffuse cutaneous leishmaniasis. Cutaneous leishmaniasis, caused by Leishmania mexicana, was initially diagnosed from lesions confined to the left ear. A radical pinnectomy was done and the cat was returned to its owner. Two years later, lesions developed at the stump, and lesions later developed on the cat's muzzle and nasal mucosa. All of the lesions contained numerous L mexicana amastigotes. Several treatment regimens were attempted, but without evidence of resolution. The cat was tested multiple times for evidence of impaired immunologic competence and was found to be normal. The cat failed to respond to Leishmania antigen given interdermally (Montenegro test) on several occasions. On one occasion, however, there was partial regression of the lesions following the Montenegro test. Cats in areas endemic for cutaneous leishmaniasis (South Texas) may serve as sentinels for the agent. The epidemiology of the infection in this area is largely unknown, as is the importance of cats in the spread of disease.

Animals↗
PubMed1994

Infection of BALB/c, C57B1/6 mice and F1 hybrid CB6F1 mice with strains of Leishmania mexicana isolated from Mexican patients with localized or diffuse cutaneous leishmaniasis.

Mice from the syngeneic strains BALB/c, C57B1/6 and (BALB/cxC57B1/6)F1 hybrids (CB6F1) were infected in the footpad with six different strains of Leishmania mexicana mexicana isolated from Mexican patients. Three Leishmania strains were isolated from patients with localized cutaneous leishmaniasis (LCL, the benign form of the disease) and three from patients with diffuse cutaneous leishmaniasis (DCL, the malignant form of the disease). In BALB/c mice, four Leishmania strains showed a sustained fast growth from 4 to 5 weeks postinfection until the end of the experiment (15 weeks), and the other two grew slowly up to 10 or 12 weeks after infection and then started to grow faster. In C57B1/6 mice four Leishmania strains showed a limited to moderate growth up to 6 to 11 weeks postinfection and then started to decrease. One strain showed a moderate growth during the entire experiment and one strain grew as fast as in BALB/c mice up to 11 weeks postinfection and then started to decrease. The CB6F1 hybrid behaved like the C57B1/6 parent strain with five Leishmania strains but was much more resistant to one Leishmania strain than the C57B1/6 mice. Sex of the mouse did not influence the outcome of infection. One important purpose of this work was to see if the Leishmania strains that cause DCL are intrinsically more virulent than those that cause the benign form (LCL). Although important variations in virulence among the Leishmania strains were observed, especially in BALB/c mice, they were not correlated with the type of disease caused in humans.

Animals↗
PubMedDate not supplied

[The current status of diffuse cutaneous leishmaniasis (DCL) in the state of Maranhão. II. The epidemiological and clinico-evolutionary aspects].

The authors describe a retrospective and prospective study of 6 patients with diffuse cutaneous leishmaniasis observed in the state of Maranhão, since 1974. The patients come from different rural regions of the state and in all of them Leishmania (Leishmania) amazonensis was the cause five of the patients initiated their disease in the first decade of life. All the patients first had a solitary, nodular lesion, that after a variable period of time, disseminated and acquired other aspects. Sequentially the patients presented multiple nodular and ulcerative lesions, negative Leishmania skin tests and a refractory response to the therapeutic schedules used up to the present.

Adolescent↗
PubMed1980

[Transfer factor in diffuse cutaneous leishmaniasis. Experience with one case].

Transfer factor was administered in one case of Diffuse Cutaneous Leishmaniasis ("DCL") with minimal therapeutical results after two courses of ten doses each. The patient was 34-year-old white man, born in the State of Pará --Amazon-- region, goldwasher, his disease started 9 years ago and consisted of disseminated papular and nodular lesions, some of them secondarily ulcerated and more closely clustered over the knees elbows and dorsa of the hands. Physical examination was normal except for the skin lesions and a perforation of the nasal septum. Some intradermal tests (Paracoccidiodin, Lepromin and PPD) were positive while the Montenegro (leishmanin) reaction was negative. Increased levels of IgG and IgM were found; IgA was normal even after the treatment. Transfer Factor was obtained from leishmanin positive and PPD strong reactors and the method of preparation is described. By the end of the first ten-doses course, lesions were reduced to dark atrophic residual macules but the histological sections displayed a surprising amount of parasites, predicting unavoidable relapse. For the second series, as the patient refused to be given Amphotericin B he was treated with hot baths and levamisole was administered in a 150 mg daily dosage and 45 days cycles. The leishmanin intradermal test did not became positive after the treatment and this fact is discussed.

Adult↗
PubMed2007

Diffuse cutaneous leishmaniasis in an HIV-positive patient in western Africa.

A 36-year-old HIV1-positive woman presented with a 6-month history of a progressive papular and nodular eruption of the face and subsequent extensive spread to the rest of the skin. The diagnosis of diffuse cutaneous leishmaniasis was established by direct examination and skin biopsy. This atypical form had a dramatic improvement after a 21-day treatment with meglumine antimoniate. This clinical form may be confused with other endemic diseases in western Africa, especially leprosy.

Africa, Western↗
PubMed1983

[Diffuse cutaneous leishmaniasis. Anatomo-pathologic aspects].

We present a study of 21 biopsies from three patients with diffuse cutaneous leishmaniasis with periods of observation of up to 9 years. The biopsies were taken before, during, and after specific treatment. We observed that a lymphocytic infiltrate may be present in the lesions and that the intensity of the infiltrate is variable from lesion o lesion, even among lesions biopsied at the same time. Tuberculoid granulomatous reactions were not found in the patients following treatment. We conclude that the histologic features of importance in the classification of cutaneous leishmaniasis are: the tuberculoid granulomatous reaction and the intensity of parasitism.

Biopsy↗