el Hassan A M, Ghalib H W, Zijlstra E E, Eltoum I A, Satti M, Ali M S, Ali H M
Leishmaniasis Research Group, Medical Research Council, Khartoum, Sudan.
Trans R Soc Trop Med Hyg. 1992 May-Jun;86(3):245-8. doi: 10.1016/0035-9203(92)90294-m.
The clinical features, pathology, immune responses, diagnosis and treatment of post kala-azar dermal leishmaniasis (PKDL) in the Sudan are described and discussed. The disease is characterized by maculopapular or nodular lesions on the face, limbs or trunk. Lesions appear during or within months after the treatment of visceral leishmaniasis, but in 2 of 19 patients there was no previous history of kala-azar. PKDL may be confused with leprosy both clinically and pathologically. Similarities and differences between the 2 diseases are discussed. Unlike visceral leishmaniasis, the peripheral lymphoid cells of patients with PKDL respond to Leishmania antigen and some are leishmanin positive. The response to intravenous sodium stibogluconate (20 mg/kg for 30 d) was reasonably good but some patients required repeated or more prolonged treatment. Ketoconazole in a dose of 10 mg/kg daily for 4 weeks had no effect on PKDL.
本文描述并讨论了苏丹黑热病后皮肤利什曼病（PKDL）的临床特征、病理学、免疫反应、诊断及治疗。该病的特征为面部、四肢或躯干出现斑丘疹或结节性病变。病变出现在内脏利什曼病治疗期间或治疗后的数月内，但19例患者中有2例既往无黑热病病史。PKDL在临床和病理上可能与麻风混淆。文中讨论了这两种疾病的异同。与内脏利什曼病不同，PKDL患者的外周淋巴细胞对利什曼原虫抗原有反应，部分患者利什曼素阳性。静脉注射葡萄糖酸锑钠（20mg/kg，共30天）的疗效尚可，但部分患者需要重复治疗或延长疗程。酮康唑每日10mg/kg，连用4周对PKDL无效。
