ABSTRACT
Introduction: Cutaneous Leishmaniasis [CL] has 2 principal clinical forms in Iran: Anthroponotic and Zoonotic. These forms, previously called Dry and wet forms, are caused by Leishmania tropica and L. major respectively. Formerly, diagnosis of different forms was based on epidemiological status and clinical signs; but at present, definite diagnosis by advanced laboratory tests such as ELISA and Isoenzyme methods is possible. In order to investigate correlation between ELISA test, clinical appearance, and skin test, a study was undertaken in Emam Reza Hospital, Mashhad
Material and Methods: The study population was selected among the volunteers who had suspected skin lesions for C.L. Direct smear, culture and Leishmanin skin test was performed for 153 patients. ELISA using specific monoclonal antibodies [SMA] performed species determination
Results: The minimum and maximum ages of the patients were 19 months and 97 years old respectively. Most of the patients were Females [63.9%]. Among 72 patients whose cutaneous lesions were approved for Leishmaniasis, 91.6% had ulcers with dry appearance and 8.4% had appearance of wet form C.L. The etiologic agents isolated from the skin lesions of the latter patients were L.tropica [66.6%], L.major [28.8%] and unknown form [4.2%]. Among the patients who had skin lesions with wet appearance, the isolated agents were L.tropica [5.6%], L.major [1.4%] and unknown form [1.4%]. The sensitivity of Leishmanin Skin Test was higher in-patients infected by L. major
Conclusion: ELISA method using SMA is a sensitive and reliable test for differential diagnosis of Anthroponotic Cutaneous Leishmaniasis [ACL] and Zoonotic Cutaneous Leishmaniasis [ZCL]. Both ACL and ZCL are present in Mashhad. ACL is three times more prevalent than ZCL. Clinical appearance is not a valid factor for determination of species of Leishmania. The sensitivity of Leishmanin Skin Test is higher in wet form in relation to dry form. There may be other species of Leishmania causing cutaneous lesions in Mashhad