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CLINICAL AND IMMUNOPATHOLOGICAL ASPECTS OF DISSEMINATED CUTANEOUS LEISHMANIASIS
Leishmaniose cutânea
Leishmaniose cutânea disseminada
Leishmaniose tegumentar
Imunologia em leishmaniose
Cutaneous leishmaniasis
Disseminated cutaneous leishmaniasis
Tegumentary leishmaniasis
Immunology in leishmaniasis
Author
Affilliation
Hospital Universitdrio Professor Edgard Santos. Departamento de Patologia. Service de Imunologia. Salvador, BA, Brasil
Hospital Universitdrio Professor Edgard Santos. Departamento de Patologia. Service de Imunologia. Salvador, BA, Brasil
Universidade Federal do Maranhão. São Luís, MA, Brasil
Hospital Universitdrio Professor Edgard Santos. Departamento de Patologia. Service de Imunologia. Salvador, BA, Brasil
Universidade de Brasilia. Brasília, DF, Brasil
Hospital Universitdrio Professor Edgard Santos. Departamento de Patologia. Service de Imunologia. Salvador, BA, Brasil
Universidade Federal do Maranhão. São Luís, MA, Brasil
Hospital Universitdrio Professor Edgard Santos. Departamento de Patologia. Service de Imunologia. Salvador, BA, Brasil
Universidade de Brasilia. Brasília, DF, Brasil
Abstract
The ciinico-pathological and immunological findings in eight patients from Bahia, Brazil with disseminated
cutaneous leishmaniasis are described. This condition differs from anergic diffuse cutaneous leishmaniasis
(DCL) and from classical American cutaneous leishmaniasis (ACL). The number of lesions in these
patients ranged from 75 to 800 and were characterized by papules and an acneiform type of lesion with a
few ulcers rather than nodules that are the main characteristic of DCL. On the other hand the high
incidence of mucosal disease (38%) in patients with disseminated cutaneous leishmaniasis make the prevalence
of mucosal involvement in this condition higher than that observed in ACL. L. amazonensis (five
cases) and L. braziliensis (two cases) were the causal agents in the patients where the infecting agent was
characterized. Antibody titers in disseminated cutaneous leishmaniasis were higher than those observed in
ACL and patients with the highest antibody titers had mucosal envolvement. Abnormalities in cellular
immunity that are not observed in ACL such as decrease in CD4 + cells and absence of T cell response to
leishmania antigen were observed in several patients with disseminated cutaneous leishmaniasis but
restoration of these abnormalities occurred after treatment. In spite of the great number of lesions, the
therapeutic response was good in six patients with disappearance of the lesions in a period shorter than
that observed in ACL. In the two patients that presented therapeutic failure the causal agent was L.
amazonensis. In such patients there was a predominance of ulcerated lesions, and a high titer of antibody
was detected
Keywords in Portuguese
LeishmanioseLeishmaniose cutânea
Leishmaniose cutânea disseminada
Leishmaniose tegumentar
Imunologia em leishmaniose
Keywords
LeishmaniasisCutaneous leishmaniasis
Disseminated cutaneous leishmaniasis
Tegumentary leishmaniasis
Immunology in leishmaniasis
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