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. 2013 Jun;107(4):194-7.
doi: 10.1179/2047773213Y.0000000097.

Cutaneous and post kala-azar dermal leishmaniasis caused by Leishmania infantum in endemic areas of visceral leishmaniasis, northwestern Iran 2002-2011: a case series

Alireza Badirzadeh  1 , Mehdi Mohebali, Mehrdad Ghasemian, Hassan Amini, Zabiholah Zarei, Behnaz Akhoundi, Homa Hajjaran, Dariush Emdadi, Soheila Molaei, Ahmad Kusha, Saber Alizadeh
Affiliations

Cutaneous and post kala-azar dermal leishmaniasis caused by Leishmania infantum in endemic areas of visceral leishmaniasis, northwestern Iran 2002-2011: a case series

Alireza Badirzadeh et al. Pathog Glob Health. 2013 Jun.

Abstract

Visceral leishmaniasis (VL) is endemic in Northwest and southern Iran. Reports of cutaneous leishmaniasis (CL) in Northwest areas are rare, and its etiological agents are unknown. In the current study, we report six CL and two post kala-azar dermal leishmaniasis (PKDL) cases caused by Leishmania infantum from endemic areas of VL in the Northwest. Smears were made from skin lesions of 30 suspected patients in 2002-2011, and CL was determined by microscopy or culture. Leishmania spp. were identified by nested-PCR assay. The disease was confirmed in 20 out of 30 (66%) suspected patients by parasitological examinations. L. infantum was identified in eight and Leishmania major in 12 CL cases by nested-PCR. Cutaneous leishmaniasis patients infected with L. major had the history of travel to CL endemic areas. L. infantum antibodies were detected by direct agglutination test (DAT) at titers of 1:3200 in two cases with history of VL. Results of this study indicated that L. infantum is a causative agent of CL as well as PKDL in the VL endemic areas.

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Figures

Figure 1
Figure 1
Nested-PCR-based amplification of kDNA extracted from Giemsa-stained lesion smears; lane 1: negative control; lanes 2, 3, 4, and 5: positive samples of CL patients due to Leishmania infantum; lane 6: 100–1500 bp molecular-weight ladder (Roche); lanes 7, 8, and 9: positive control of L. infantum (680 bp); L. tropica (750 bp); and Leishmania major (560 bp), respectively.
Figure 2
Figure 2
Post kala-azar dermal leishmaniasis (PKDL) due to Leishmania infantum, DAT positive and history of visceral leishmaniasis (VL) from Ardabil province.
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