Department of Dermatology, Tufts Medical Center and Miraca Life Sciences, Boston, MA, USA.
Int J Dermatol. 2013 Apr;52(4):446-55. doi: 10.1111/j.1365-4632.2012.05709.x. Epub 2012 Dec 11.
Leishmaniasis is a diverse group of vector-borne diseases caused by a subset of predominantly intracellular protozoal species of the genus Leishmania. Cutaneous disease may be subdivided into localized, intermediate, and diffuse forms. Intermediate cutaneous leishmaniasis is distributed widely in Latin America and is characterized by cutaneous lesions, which may be accompanied by mucosal disease and demonstrate a tendency toward chronicity and relapse as well as resistance to standard treatment regimens. Leishmania parasites of the subgenus Viannia have been identified as the major etiologic agent of this subset of infections. The present review provides a brief perspective on leishmaniasis followed by a review of classification, transmission, clinical presentation, and evolution of disease, immunology, and current treatment approaches for the intermediate/borderline disseminated subset of cutaneous leishmaniasis.
利什曼病是一组由利什曼属的主要细胞内原生动物种引起的多种虫媒疾病。皮肤疾病可分为局限性、中间性和弥漫性。中间性皮肤利什曼病广泛分布于拉丁美洲,其特征是皮肤损伤,可能伴有粘膜疾病,并表现出慢性、复发以及对标准治疗方案的耐药性。已鉴定出亚属 Viannia 的利什曼原虫是该组感染的主要病原体。本综述简要介绍了利什曼病,随后综述了中间/边界播散性皮肤利什曼病的分类、传播、临床表现和疾病演变、免疫学以及当前的治疗方法。