Dados do Trabalho

Título

CLINICAL PROFILE AND DIAGNOSIS OF RECURRENT CUTANEOUS LEISHMANIASIS

Introdução

Recurrent cutaneous leishmaniasis (RCL) occurs in about of 4% of the patients, following treatment and cure.Usually, RCL occurs more than 5 years after cure of the first episode of leishmaniasis and the secondary ulcer is located in a different region than the primary lesion. In a previous report, we observed that the skin parasite load was higher in patients with primary CL (PCL) compared to RCL.

Objetivo (s)

From January 2020 to December of 2021, we observed an increase in the number of RCL cases in the Health Post of Corte de Pedra and in this brief report, we performed a case-control study, comparing RCL and PCL patients with regards to demographic and clinical parameters to determine the clinical profile and discuss the diagnosis of these patients.

Material e Métodos

This is a case-control study conducted in Brazil between 2020 and 2021, which included 41 PCL patients and 20 RCL patients.The study recorded the demographic and clinical features, the size of the induration of the leishmanial skin test (LST), and the treatment outcomes of the patients.The diagnosis of CL was confirmed by performing a delayed type hypersensitivity reaction to leishmania (LST) with soluble leishmania antigen (SLA), and by documenting the presence of DNA of L. braziliensis in biopsied lesions.Histopathological analysis of the lesions was conducted, and the number of amastigotes was quantified by immunohistochemistry staining.

Resultados e Conclusão

In this study, 61 patients were included, 20 with recurrent cutaneous leishmaniasis (RCL) and 41 with primary cutaneous leishmaniasis (PCL).The measurement of risk in OR cannot be included, since the small sample would provide a less accurate OR, the survey of a larger sample is in progress for a subsequent cohort study.RCL patients had longer illness duration (P=0.04), fewer lesions (P=0.04), and higher LST induration (P=0.01) compared to PCL patients.The cure rate was similar between the two groups when only considering patients who self-healed or were cured at day 90 (P=0.13).PCR detection of leishmanial DNA was negative in 82.9% of RCL cases compared to 20% in PCL cases (P=0.0001), and the number of amastigotes was significantly lower in RCL patients (P=0.01).Clinically showed that RCL lesions were more superficial with less infiltrated borders and smaller size.Overall, these findings suggest that RCL patients have a better ability to control parasite replication.

Palavras-chave

Leishmania braziliensis,clinical manifestation,recurrent leishmaniasis

Agradecimentos

NIH INCTDT FAPESB