Hashemi Seyyede Neda, Mohebali Mehdi, Mansouri Parvin, Bairami Amir, Hajjaran Homa, Akhoundi Behnaz, Charehdar Soorour
Department of Dermatology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2011;49(3):136-41.
Cutaneous leishmaniasis (CL) is an endemic disease in some parts of Iran and it has high morbidity in some areas of the country. The disease is detected by parasitological examinations including direct microscopic and culture tests. This comparative study aimed to evaluate the relationship between positivity of the leishmanin skin test (LST), microscopically examination and clinical forms of CL for the diagnosis of human cutaneous leishmaniasis. This study was performed on 66 patients suspected to cutaneous leishmaniasis. CL cases evaluated by both microscopical examination and leishmanin skin test. In this study, 1 ml of leishmanin fluid (lot no 121/1, produced in Pasteur institute of Iran) was injected intradermally in forearms of all patients and indurations were measured after 72 hours. Induration of 5 mm and higher was considered as positive results. The collected data were statistically analyzed using the SPSS version 13.5. From 66 CL patients who were evaluated in this study, 30 (45.5%) of them had positive microscopically results while 28(42/4%) of them had showed positive leishmanin skin test (≥ 5 mm diameter). From 36 (54.5%) patients who had negative microscopical examination, only 6(16/6%) of them had positive leishmanin skin test. The agreement between two tests was 87.9 % by kappa analysis (p< 0.01). In attention to the results of this study, it seems the LST would be used as an alternative diagnosis method when there is a strong clinical doubt to cutaneous leishmaniasis even there is no parasite in direct smear.
皮肤利什曼病（CL）是伊朗部分地区的一种地方病，在该国一些地区发病率很高。该疾病通过包括直接显微镜检查和培养试验在内的寄生虫学检查来检测。这项比较研究旨在评估利什曼原虫皮肤试验（LST）阳性、显微镜检查与CL临床形式之间的关系，以诊断人类皮肤利什曼病。本研究对66例疑似皮肤利什曼病的患者进行。CL病例通过显微镜检查和利什曼原虫皮肤试验进行评估。在本研究中，将1毫升利什曼原虫液（批号121/1，由伊朗巴斯德研究所生产）皮内注射到所有患者的前臂，72小时后测量硬结。硬结5毫米及以上被视为阳性结果。使用SPSS 13.5版本对收集的数据进行统计分析。在本研究评估的66例CL患者中，30例（45.5%）显微镜检查结果为阳性，而其中28例（42.4%）利什曼原虫皮肤试验呈阳性（直径≥5毫米）。在36例（54.5%）显微镜检查为阴性的患者中，只有6例（16.6%）利什曼原虫皮肤试验呈阳性。通过kappa分析，两种试验之间的一致性为87.9%（p<0.01）。鉴于本研究的结果，当对皮肤利什曼病有强烈临床怀疑时，即使直接涂片未发现寄生虫，LST似乎也可作为一种替代诊断方法。
