Journal of Education and Health Promotion

Identification of etiologic agents of cutaneous Leishmaniasis in palpebral position followed by effective therapy

Authors

. Sedigheh Saberi 1
. Reza Arjmand 2
. Ali Khamesipour 3
. Mohammad Ali Nilforoushzadeh 4
. Shaghayegh Sayareh 2
. Seyed Hossein Hejazi 5

1 Department of Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical SciencesSkin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz

3 Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences

4 Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycology, Isfahan University of Medical Sciences, Isfahan

Abstract
CONTEXT: Cutaneous Leishmaniasis (CL) is a self‑healing lesion but prevention of complications
and involvement of vital organs such as palpebra requires proper treatment.
AIMS: The main objectives were to detect agents of CL in palpebral region and estimate the proportion
of palpebral lesion also possible complications among CL patients in a zoonotic CL endemic area.
SETTINGS AND DESIGN: The study was performed from April 2012 to March 2013 in a total of
1613 CL suspected patients by interview and physically exam.
SUBJECTS AND METHODS: The samples were used for direct smear using Giemsa stain method, or
cultured in Novy‑McNeal‑Nicol medium. For further checked, nested polymerase chain reaction (PCR)
was used for negative palpebral samples. Of the 1613 examined samples, 848 (81.4%) by direct
smear, 188 (18%) by culture and 6 (0.6%) by nested PCR were positive, respectively. A total of 233
of the patients showed lesions on the face of whom 15 (male = 5, female = 10, 1.43% of all and
6.43% of facial lesions) presented with palpebral CL. The results of nested PCR indicated that all
the palpebral cases were due to Leishmania major.
CONCLUSIONS: About 93% of the patients with palpebral lesion were under 5 years old and were
infected in the hyper endemic regions, but no ocular complication was seen in any of them. Based
on the results, it seems that early referring to the medical center for proper diagnosis and treatment
is the main reason for prevention of further complications.

Keywords

Cutaneous Leishmaniasis
facial lesion
Iran
ocular effects
palpebral position
1. Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, et al.
Leishmaniasis worldwide and global estimates of its incidence.
PLoS One 2012;7:e35671.
2. Word Health Organization. Control of the Leishmaniases: Report
of a Meeting of the WHO Expert Commitee on the Control of
Leishmaniases. Geneva: Word Health Organization; 2010. p. 22‑6.
3. Modarreszadeh M, Manshai K, Shaddel M, Oormazdi H. Ocular
Leishmaniasis. Iran J Ophthalmol 2006;19:1‑5.
4. Arfan‑ul‑Bari, Inam‑ul‑Haq, RaniM. Lid leishmaniasis: An atypical
clinical presentation. J Coll Physicians Surg Pak 2006;16:725‑6.
5. Abboud IA, Ragab HA, Hanna LS Experimental ocular
leishmaniasis. Br J Ophthalmol 1970;54:256‑62.
6. Abrishami M, Soheilian M, Farahi A, Dowlati Y. Successful
treatment of ocular leishmaniasis. Eur J Dermatol 2002;12:88‑9.
7. Morgan G. Case of cutaneous leishmaniasis of the lid. Br J
Ophthalmol 1965;49:542‑6.
8. Jafari AK, Akhyani M, Valikhani M, Ghodsi ZS, Barikbin B,
Toosi S. Bilateral cutaneous leishmaniasis of upper eyelids: A
case report. Dermatol Online J 2006;12:20.
9. Aouchiche M, Hartani D. Ophtalmic involvement in cutaneous
leishmaniasis (author’s transl). Med Trop (Mars) 1981;41:519‑22.
10. Veraldi S, Bottini S, Currò N, Gianotti R. Leishmaniasis of the
eyelid mimicking an infundibular cyst and review of the literature
on ocular leishmaniasis. Int J Infect Dis 2010;14 Suppl 3:e230‑2.
11. Bari AU. Clinical spectrum of cutaneous leishmaniasis: An
overview from Pakistan. Dermatol Online J 2012;18:4.
12. Mohammadi AM, Khamesipour A, Khatami A, Javadi A,
Nassiri‑Kashani M, Firooz A, et al. Cutaneous leishmaniasis in
suspected patients referred to the center for research and training
in skin diseases and leprosy, tehran, iran from 2008 to 2011. Iran
J Parasitol 2013;8:430‑6.
13. Noyes HA, Reyburn H, Bailey JW, Smith D. A nested‑PCR‑based
schizodeme method for identifying Leishmania kinetoplast
minicircle classes directly from clinical samples and its application
to the study of the epidemiology of Leishmania tropica in Pakistan.
J Clin Microbiol 1998;36:2877‑81.
14. Nadim A, Seyedi‑Rashti M. A brief review of the epidemiology of
various types of leishmaniasis in Iran. Acta Med Iran 1971;14:99‑106.
15. Rivas L, Moreno J, Cañavate C, Alvar J. Virulence and disease in
leishmaniasis: What is relevant for the patient? Trends Parasitol
2004;20:297‑301.
16. Satici A, Gurler B, Aslan G, Ozturk I. Ocular involvement in
cutaneous leishmaniasis four cases with blepharoconjunctivitis.
Eur J Epidemiol 2004;19:263‑6.
17. Khamesipour A, Dowlati Y, Asilian A, Hashemi‑Fesharki R,
Javadi A, Noazin S, et al. Leishmanization: Use of an old method
for evaluation of candidate vaccines against leishmaniasis.
Vaccine 2005;23:3642‑8.
18. Alvar J, Croft SL, Kaye P, Khamesipour A, Sundar S, Reed SG.
Case study for a vaccine against leishmaniasis. Vaccine
2013;31 Suppl 2:B244‑9.
19. Nadim A, FaghihM. The epidemiology of cutaneous leishmaniasis
in the Isfahan province of Iran. I. The reservoir. II. The human
disease. Trans R Soc Trop Med Hyg 1968;62:534‑42.
20. Yaghoobi R, Maraghi S, Bagherani N, Rafiei A. Cutaneous
leishmaniasis of the lid: A report of nine cases. Korean J
Ophthalmol 2010;24:40‑3.
21. AyatollahiJ, AyatollahiA, ShahcheraghiSH. Cutaneous leishmaniasis
of the eyelid: A case report. Case Rep Infect Dis 2013;2013:214297.
22. Sadeghian G, Nilfroushzadeh MA, Moradi SH, Hanjani SH.
Ocular leishmaniasis: A case report. Dermatol Online J 2005;11:19.
23. Mencía‑Gutiérrez E, Gutiérrez‑Díaz E, Rodríguez‑Peralto JL,
Monsalve‑Córdova J. Old world eyelid cutaneous leishmaniasis:
A case report. Dermatol Online J 2005;11:29.
Journal of Education and Health Promotion
Volume 7, Issue 3
May and June 2017
Pages 1-6

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us