Clinical presentations of Cutaneous Leishmaniasis
Dr Mohammad Ali Nilforoushzadeh M.D, Dermatologist Associate Professor of Tehran University Fellowship of Laser and Aesthetic Dermatology
Background:
Leishmaniasis is a protozoal disease • capable of causing a spectrum of clinical syndromes ranging from cutaneous ulcerations to systemic infections. With the exception of Australia and • Antarctica, the parasites have been identified throughout the world
Epidemiology:
Leishmaniasis can be found in more than 80 countries. The World Health Organization reports an annual incidence of 600,000 cases per year. An estimated 12-million people are infected from a population of 350-million people who are at risk. Of these infections, approximately 25% are of visceral leishmaniasis, most of which come from the Indian subcontinent, Sudan, and Brazil. In contrast, most cases of localized cutaneous leishmaniasis come from Afghanistan, Saudi Arabia, Syria, Iran, and the Americas. • •
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Background:
Traditionally divided between Old World • and New World parasites, more than 20 pathogenic species have been identified. Common Old World hosts are domestic • and feral dogs, rodents, foxes, jackals, wolves, raccoon-dogs, and hyraxes. Common New World hosts include sloths, • .anteaters, opossums, and rodents
Background:
The protozoa are transmitted to mammals via the bite of the female sandfly. Humans generally are considered incidental hosts. For most species of Leishmania, an animal reservoir is required for endemic conditions to persist. Infections in wild animals usually are not pathogenic, with the exception of dogs, which may be severely affected. • • • •
Life Cycle of Leishmania
Numerous Leishman bodies in a macrophage from a skin smear stained with Giemsa
Parasites in the Macrophage:
Leishmania - Sandfly (Phlebotimus)
Leishmania - Sandfly (Phlebotimus