急性皮肤利什曼病患者中利什曼原虫素皮肤试验的敏感性

Sensitivity of leishmanin skin test in patients of acute cutaneous leishmaniasis.

作者信息

Manzur A, Bari Arfan ul

机构信息

Department of Dermatology, PAF Hospital Sargodha, Pakistan.

出版信息

Dermatol Online J. 2006 May 30;12(4):2.

DOI:
Abstract

BACKGROUND

The leishmanin skin test (LST) is frequently used for clinical diagnosis of cutaneous leishmaniasis (CL). Although, LST is highly sensitive for CL, no definitive data exists as to how early in the disease does the test becomes positive.

OBJECTIVE

The study was aimed to evaluate the sensitivity of LST in early cases of CL.

PATIENTS AND METHODS

One hundred male patients with CL of not more than 2-weeks duration and having parasitologically proven diagnosis were enrolled in this study, carried out in a military hospital in Balochistan, Pakistan. LST was done by intradermal injection of 0.1 ml leishmanin on the volar surface of the forearm. The skin test reaction was read after 48 hours and then at 72 hours if the first reading was negative or marginal. If the initial test was negative, the LST was repeated after every 7 days until a positive reaction was produced. The total time from the onset of skin lesions until a positive LST was obtained was recorded for every patient.

RESULTS

A positive LST was demonstrated in 78/100 patients with skin lesions of <or= 2 weeks duration, thus showing a sensitivity of 78 percent for this short duration. The sensitivity of LST increased to 94 percent and 98 percent for CL lesions of 4 and 6 weeks duration, respectively.

CONCLUSION

LST is sensitive even in those CL patients who present with lesions of very recent onset. Thus the test can be employed with confidence, for the diagnosis of CL, even in early disease.

摘要

背景

利什曼原虫皮肤试验(LST)常用于皮肤利什曼病(CL)的临床诊断。尽管LST对CL高度敏感,但关于该试验在疾病早期何时呈阳性尚无确切数据。

目的

本研究旨在评估LST在CL早期病例中的敏感性。

患者与方法

本研究纳入了100名男性CL患者,病程不超过2周且经寄生虫学确诊,研究在巴基斯坦俾路支省的一家军队医院进行。通过在前臂掌侧皮内注射0.1 ml利什曼原虫悬液进行LST。48小时后读取皮肤试验反应,若首次读数为阴性或临界值,则在72小时后再次读取。若初始试验为阴性,则每7天重复一次LST,直至产生阳性反应。记录每位患者从皮肤病变出现到获得阳性LST的总时间。

结果

100例病程≤2周的皮肤病变患者中,78例LST呈阳性,因此在这一短病程中显示出78%的敏感性。对于病程4周和6周的CL病变,LST的敏感性分别增至94%和98%。

结论

即使在那些近期发病的CL患者中,LST也很敏感。因此,即使在疾病早期,该试验也可放心用于CL的诊断。

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