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J Am Acad Dermatol ; 28(6): 927-32, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8496456

ABSTRACT

BACKGROUND: Leishmaniasis, a chronic parasitic disease transmitted by Phlebotomus sandflies, affects millions of patients. Mucocutaneous leishmaniasis caused by Leishmania brasiliensis is endemic in much of South America. OBJECTIVE: Our purpose was to develop a system for staging mucocutaneous leishmaniasis on the basis of clinical, histopathologic, epidemiologic, and immunologic criteria. METHODS: Seventy-five Bolivian patients with mucocutaneous leishmaniasis were evaluated by history and physical examination; cutaneous, mucosal, and bone marrow biopsy specimens; and immunologic assessment. RESULTS: Mucocutaneous leishmaniasis may progress through three clinical stages: (1) the primary or cutaneous, (2) the cicatricial, and (3) the secondary or mucocutaneous stages. The primary stage can be further subdivided into three phases: lymphoplasmocytic, tuberculoid, and diffuse cutaneous phases. The secondary stage can also be subdivided into three phases: edematous, granulomatous proliferative, and granulomatous necrotizing stages. CONCLUSION: A classification or staging system enhances the ability to evaluate patients with mucocutaneous leishmaniasis and determine more accurately their prognosis and treatment.


Subject(s)
Leishmaniasis, Mucocutaneous/classification , Skin/pathology , Adult , Biopsy , Bolivia/epidemiology , Female , Humans , Leishmaniasis, Cutaneous/classification , Leishmaniasis, Diffuse Cutaneous/classification , Leishmaniasis, Mucocutaneous/epidemiology , Leishmaniasis, Mucocutaneous/pathology , Male
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