Cutaneous leishmaniasis - forms , symptoms and treatment


1. Classification

2. development of disease

3. symptoms of leishmaniasis

4. Treatment of leishmaniasis

Leishmaniasis - is a group of diseases,which are caused by the vital activity of the simplest kind of Leishmania parasites.The parasite is transmitted to humans through the bites of mosquitoes that live in tropical and subtropical countries.The disease occurs in 88 countries of the Old World and New World, of which 72 are developing and 13 - to the poorest.Methods of prevention and treatment of leishmaniasis are well known, but are not available in the poorest countries, so they are called "neglected diseases".

Classification There are two main forms of leishmaniasis.Visceral leishmaniasis affects the bone marrow cells and the reticuloendothelial system.In different countries, it is called a "black fever" Dum-Dum fever.This is the most severe form of leishmaniasis, which occurs in Africa, South Asia, the Mediterranean, South America and annually claims the lives of

more than 50 thousand people.Cutaneous leishmaniasis is known as leishmaniasis, rubber ulcer pendinskaya ulcers and so on.The disease affects the skin and subcutaneous tissue and mucous membranes.It circulated in areas where the temperature drops no lower than 20 ° C - in Turkmenistan, Uzbekistan, Afghanistan, in the rain forests of Central and South America.


Leishmaniasis disease causing protozoa of the genus Leishmania, which are developing in the gut of mosquitoes females.During the bite the female insect releases into the skin infected saliva.In one bite into the skin falls between 100 and 1000 parasites that reached a stage of development promastigote.Leishmania into macrophages can penetrate without causing an immune response to intracellular transformed shape adapted to the acidic environment of the host, and then actively proliferate.The disease can be transmitted by mosquitoes to man and from man to mosquito, these types of leishmaniasis called anthroponotic.For some other species of protozoa characterized by transmission from animals to mosquitoes and then to a man like form of the disease called zoonotic.

symptoms of leishmaniasis

most common form - visceral leishmaniasis Mediterranean-Asian origin.The incubation period takes from 20 days to 3-5 months.In rare cases of leishmaniasis symptoms may occur within a year after infection.Visceral leishmaniasis is rare in adults, in children bite mosquito develops primary papule.The development of the disease can be acute, subacute and chronic.Without treatment leishmaniasis in an acute form quickly leads to death.Symptoms of subacute forms of leishmaniasis are weakness, fatigue, weakness, loss of appetite, pale skin.On palpation can detect an enlarged spleen.Wherein the temperature is kept near 38 ° C, but if the rate increases, it means that the disease becomes crisis period.Symptoms of fever occur in waves and may be followed by periods of lull, but not recovery.This change periods can last for two or three months.On closer examination the doctor can detect more characteristic symptoms of leishmaniasis - enlarged lymph nodes, abnormal enlargement and tenderness of the liver and spleen.Against the background of the disease may develop a cough and secondary pneumonia.As the progression of the disease develop anemia, a sharp exhaustion and hemorrhagic syndrome.In the oral mucosa appears necrotic areas.With the development of heart disease moves to the right to work at an accelerated pace, peripheral blood pressure falls, heart failure develops.In the chronic form of leishmaniasis symptoms are negligible.In 10% of cases, the skin may appear small papillomas, nodules and spots, lacking pigmentation, they can detect the pathogen.

Borowski disease or cutaneous leishmaniasis zoonotic type has an incubation period of 10-20 days.As a rule, on the site of the bite formed smooth papule with a diameter of 2-3 cm, which eventually turns into a painless or almost painful boil.But within two weeks, or earlier at this site will develop necrotic focus, which in turn turns into a painless ulcer with podrytymi kroyami and copious purulent discharge.Next comes the development of symptoms of leishmaniasis - around the original ulcers appear bumps that turn into new ulcers, as long as multiple foci do not merge into a single ulcerated field.Cutaneous leishmaniasis, usually affects exposed skin and causes an increase in regional lymph nodes.The disease lasts six months, with the formation of scars on the spot healing ulcers.

Diffuse-infiltrative leishmaniasis is rare and affects mainly the elderly.The main symptoms of this type of leishmaniasis - a massive infiltration of the skin and, in rare cases, the formation of ulcers, which usually heal without scarring.

tuberculoid cutaneous leishmaniasis, as opposed to diffuse infiltrating, it affects young people and children.This form of the disease is usually localized on the face.Other symptoms of leishmaniasis this type is the absence of ulcers in place cusps, nevertheless, hillocks can hold 10-20 years, as this type of Leishmania less virulent.

anthroponotic cutaneous leishmaniasis begins with papules unobtrusive, he has long been developing smoothly and without visible inflammatory reactions.The patient may not notice this symptom of leishmaniasis.The tubercle center you can see the central hole with dry flake-like stopper.Gradually growing papule and after 3-6 months can reach 5-10 mm, and when you remove the papules formed round the ulcer with a wrinkled bottom.Infiltration around the ulcer gradually increases its size.After a year or two, ulcer scars.

The diagnosis of the disease plays an important role skin test.The causative agent of cutaneous leishmaniasis can be distinguished from the bumps and sores.The causative agent of visceral leishmaniasis is found in blood cultures.

Treatment of leishmaniasis

to treat this type of disease used drugs pentavalent antimony - solyusurmin, klyukantim or neostibozan.In visceral leishmaniasis them administered intravenously.If the treatment of leishmaniasis does not get the desired effect, supplement the course of preparations amforteritsinom V.

In the early stages of cutaneous leishmaniasis is assigned to topical treatment - mekarpin, monomitsin sulfate beberina or methenamine applied to the bumps in the form of ointments, lotions, or cut away by local injections.If on-site papules already formed ulcers, intramuscularly appointed miramistin.For the healing of ulcers using laser therapy.In rare cases, the treatment of leishmaniasis requires surgical removal of the spleen.

addition to the treatment of leishmaniasis in areas with high risk of infection should be carried out preventive measures - elimination of mosquitoes, disinfection of premises, using repellents and individual means of protection against mosquitoes.


This article is available exclusively in the educational purposes and is not research material or professional medical advice.

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