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    ABSTRACT: Cutaneous leishmaniasis is a major world health problem. Diagnosis is suspected on evocative clinical presentation in patients living in or coming from endemic areas. Several methods have been used. The smear is a simple investigation used in endemic regions. The culture enables to identify the specimen. PCR has a high sensitivity. Montenegro's reaction is used in the epidemiological study. Pentavalent antimony derivatives remain the mainstay of systemic treatment. Their efficiency is well established. Their toxicity should be researched. Other treatments can be utilized, such as miltefosine. Local therapy is used in uncomplicated lesions. Injections of the pentavalent antimony derivate, cryotherapy and paromomycin ointmentsis are important options and should be used more frequently in Old World leishmaniasis.
    Journal of Dermatological Case Reports 06/2013; 7(2):31-41. DOI:10.3315/jdcr.2013.1135
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    ABSTRACT: Objectif Rapporter les caractéristiques épidémiologiques et cliniques de la forme érysipéloïde de leishmaniose cutanée ainsi que ses difficultés diagnostiques et thérapeutiques. Présentation du cas Une patiente de 63 ans, sans antécédents, a consulté pour une tuméfaction nasale inflammatoire évoluant depuis un mois apparue suite à un traumatisme nasal. L’examen clinique a révélé un placard érythémateux, infiltré centrofacial recouvert par endroits de croûtes. Une antibiothérapie avec des soins locaux quotidiens n’ont pas entraîné une amélioration. La biopsie cutanée n’a pas montré de signes de malignité et le frottis cutané a confirmé le diagnostic. Un traitement par méglumine antimoniale par voie intramusculaire a été instauré à la dose de 10 mg/kg par jour avec une régression partielle. Conclusion La forme érysipéloïde de leishmaniose cutanée constitue une entité rare et inhabituelle entraînant souvent un retard diagnostique. Le diagnostic repose sur l’examen parasitologique direct, la recherche de l’ADN des leishmanies par PCR et sur l’examen histologique. Il existe plusieurs options thérapeutiques. L’évolution est généralement favorable.
    04/2011; 128(2):107-109. DOI:10.1016/j.aforl.2010.12.006
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    ABSTRACT: Maghreb is known to be one of the most endemic areas of leishmaniases where both visceral and cutaneous forms are reported. Cutaneous leishmaniasis (CL) is older and has a higher prevalence than visceral one (VL). It is caused by four taxa (Leishmania (L.) major, L. infantum, L. tropica and L. killicki) which are responsible for a large clinical spectrum of lesions. Most transmission cycles of these taxa are known and many phlebotomine sandflies vectors and reservoir hosts are identified. The zoonotic transmission is well established for L. major. However, for L. infantum and L. killicki it needs more investigations to be proven. Regarding L. tropica, studies suggest it to be of both zoonotic and anthroponotic types. The isoenzymatic characterization of these four taxa showed a large enzymatic polymorphism varying from two zymodemes for L. major to 10 zymodemes for L. tropica. Cutaneous leishmaniasis is widely distributed and covers all bioclimatic stages with the coexistence of more than one taxon in the same foci. Visceral leishmaniasis is the second form of leishmaniases in Maghreb. Only L. infantum is known to cause this disease. The transmission cycle of this parasite is zoonotic but still not well known. The isoenzymatic identification of L. infantum causing VL showed the presence of six zymodemes. Geographically, VL is distributed in all bioclimatic stages of Maghreb countries. Despite all the previous studies realized on leishmaniases in Maghreb, they are still considered as neglected diseases because of the rarity or the absence of efficient control strategies.
    Acta tropica 01/2014; DOI:10.1016/j.actatropica.2013.12.018 · 2.52 Impact Factor