Vabres P, Marty P, Kauffmann-Lacroix C, Larregue M
Service de Dermatologie, Centre Hospitalier Universitaire, Poitiers.
Ann Dermatol Venereol. 2001 Oct;128(10 Pt 1):1047-50.
Localized cutaneous leishmaniasis acquired in France is rarely reported. Diagnosis usually relies on detection of leishmania on smears or by culture.
A 9-year-old child living outside endemic French Mediterranean areas had long-lasting crusted papules on the face for several months. Although the lesions were suggestive of cutaneous leishmaniasis, smears and culture were negative for Leishmania. Skin biopsy showed epithelioid and giant cell granuloma, but Leishman bodies were absent. Western Blot analysis of the patient's serum revealed antibodies directed against Leishmania infantum antigens, thus confirming the diagnosis of cutaneous leishmaniasis. Intralesional injections of meglumine antimoniate yielded complete regression of lesions.
Localized cutaneous leishmaniasis in France is caused by Leishmania infantum and may be diagnosed outside endemic Mediterranean areas, following transmission from a sandfly bite during summer holidays in Southern France. Serum analysis by Western Blot assay distinguishes between clinically active and asymptomatic Leishmania infections, the latter being common in endemic areas. Western Blot analysis is useful for the diagnosis of cutaneous leishmaniasis when parasites cannot be detected by direct techniques.
在法国获得性局限性皮肤利什曼病鲜有报道。诊断通常依靠涂片或培养检测利什曼原虫。
一名居住在法国地中海流行区以外的9岁儿童面部出现结痂丘疹长达数月。尽管这些皮损提示为皮肤利什曼病，但利什曼原虫涂片和培养均为阴性。皮肤活检显示上皮样和巨细胞肉芽肿，但未发现利什曼小体。对患者血清进行的蛋白质印迹分析显示存在针对婴儿利什曼原虫抗原的抗体，从而确诊为皮肤利什曼病。病灶内注射葡甲胺锑酸盐后皮损完全消退。
法国的局限性皮肤利什曼病由婴儿利什曼原虫引起，在法国南部暑假期间被白蛉叮咬传播后，可在非地中海流行区作出诊断。通过蛋白质印迹分析进行血清分析可区分临床活动期和无症状利什曼原虫感染，后者在流行区很常见。当无法通过直接技术检测到寄生虫时蛋白质印迹分析对皮肤利什曼病的诊断很有用。
