Cutaneous Lieshmaniasis: Advances in Disease Diagnosis and Therapeutics
Hamid Mohamed Abdalla Hamid;
Abstract
Leishmaniasis is an infectious disease caused by different species of protozoa of the genus Leishmania in the family Trypanosomatidae. Leishmaniasis is transmitted through the bite of the infected female phlebotomine sandflies.
Leishmania parasites were independently described by Willian Leishman who developed one of the earliest stains of Leishmania in 1901 and Charles Donovan in 1903. The leishmaniasis are a complex of diseases caused by at least 17 species of protozoan parasite Leishmania.
Cutaneous leishmaniasis is endemic in more than70 countries worldwide, in Africa, in part of continental Latin America, in Asia and Europe and nearly all the Arab countries and it has been given many local names.
The disease is transmitted to vertebrate host by the female infected sand fly. The female needs a blood meal for egg production some ticks and canine fleas may also act as mechanical vectors.
Sandflies are the natural vectors of the disease, approximately 30 species or subspecies of sandflies are proven vectors, with more than 40 additional species probably involved in transmission. About 800 sand fly species are medically important.
Morphologicaiy the amastigote are small, round to oval, bodies which measure about 2-5µm and found only in the macrophages of infected vertebrate hosts, the life-cycle starts when a parasitized female sandfly takes a blood meal from a human. These parasites have two basic life cycle stages: one extracellular stage with in the invertebrate host, and one intracellular stage within a vertebrate host.
Epidiologicaly the Leishmaniasis is widespread in 22 countries in the New World and in 66 nations in the Old World. Human infections are found in 16 countries, also seen in increasing numbers of military and civilian personnel deployed to whole areas.
Parasite factors and host mechanisms are inextricably linked in pathogenesis. To initially establish infection, promastigotes enter macrophages silently to evade triggering host responses; progressive intracellular (amastigote) in dermis. Infection depends on the maintenance of macrophages in an inert, deactivated state.
In early CL, epidermal changes include hyperkeratosis, basal cell degeneration, and epidermal hyperplasia, and may also consist of parakeratosis, pseudoepitheliomatous hyperplasia, follicular plugging, epidermal atrophy, acanthosis, and intraepidermal abscesses. In the dermis, where the inflammatory infiltrate consists of histiocytes, lymphocytes, and plasma cells, many intra- and extracellular amastigotes may be observed.
Clinically the human leishmanial infections may manifest in four most common forms. Depending on the causative species, it can manifest as CL, MCL, DCL, and VL. Which also commonly known as Kala-Azar.
Incubation period of CL is various, can be as short as 1-2 weeks or as long as several months people can carry some species of Leishmania asymptomatically for long periods, without becoming ill. Cutaneous leishmaniasis, often involves only the skin, and may be characterized by one to dozens of lesions. Depending on the species of Leishmania, ulcers, smooth nodules, flat plaques or hyperkeratotic wart-like lesions may be seen.
Leishmania parasites were independently described by Willian Leishman who developed one of the earliest stains of Leishmania in 1901 and Charles Donovan in 1903. The leishmaniasis are a complex of diseases caused by at least 17 species of protozoan parasite Leishmania.
Cutaneous leishmaniasis is endemic in more than70 countries worldwide, in Africa, in part of continental Latin America, in Asia and Europe and nearly all the Arab countries and it has been given many local names.
The disease is transmitted to vertebrate host by the female infected sand fly. The female needs a blood meal for egg production some ticks and canine fleas may also act as mechanical vectors.
Sandflies are the natural vectors of the disease, approximately 30 species or subspecies of sandflies are proven vectors, with more than 40 additional species probably involved in transmission. About 800 sand fly species are medically important.
Morphologicaiy the amastigote are small, round to oval, bodies which measure about 2-5µm and found only in the macrophages of infected vertebrate hosts, the life-cycle starts when a parasitized female sandfly takes a blood meal from a human. These parasites have two basic life cycle stages: one extracellular stage with in the invertebrate host, and one intracellular stage within a vertebrate host.
Epidiologicaly the Leishmaniasis is widespread in 22 countries in the New World and in 66 nations in the Old World. Human infections are found in 16 countries, also seen in increasing numbers of military and civilian personnel deployed to whole areas.
Parasite factors and host mechanisms are inextricably linked in pathogenesis. To initially establish infection, promastigotes enter macrophages silently to evade triggering host responses; progressive intracellular (amastigote) in dermis. Infection depends on the maintenance of macrophages in an inert, deactivated state.
In early CL, epidermal changes include hyperkeratosis, basal cell degeneration, and epidermal hyperplasia, and may also consist of parakeratosis, pseudoepitheliomatous hyperplasia, follicular plugging, epidermal atrophy, acanthosis, and intraepidermal abscesses. In the dermis, where the inflammatory infiltrate consists of histiocytes, lymphocytes, and plasma cells, many intra- and extracellular amastigotes may be observed.
Clinically the human leishmanial infections may manifest in four most common forms. Depending on the causative species, it can manifest as CL, MCL, DCL, and VL. Which also commonly known as Kala-Azar.
Incubation period of CL is various, can be as short as 1-2 weeks or as long as several months people can carry some species of Leishmania asymptomatically for long periods, without becoming ill. Cutaneous leishmaniasis, often involves only the skin, and may be characterized by one to dozens of lesions. Depending on the species of Leishmania, ulcers, smooth nodules, flat plaques or hyperkeratotic wart-like lesions may be seen.
Other data
| Title | Cutaneous Lieshmaniasis: Advances in Disease Diagnosis and Therapeutics | Other Titles | ليشمانيا الجلد: آخر المستجدات التشخيصية | Authors | Hamid Mohamed Abdalla Hamid | Issue Date | 2014 |
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