Mohammadi Akram Mir Amin, Khamesipour Ali, Khatami Alireza, Javadi Amir, Nassiri-Kashani Mansour, Firooz Alireza, Dowlati Yahya, Behnia Massoud, Eskandari Seyyed Ebrahim
Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Medicine, School of Medicine, Qazvin University, Qazvin, Iran.
Iran J Parasitol. 2013 Jul;8(3):430-6.
Cutaneous leishmaniasis (CL) is a major health problem in many parts of Iran, although diagnosis of CL especially in the endemic area is easy, but treatment and management of the disease is a global dilemma. Diagnosis of CL in non-endemic area is not as simple as in endemic foci. In this study, the status and the proportions of CL induced by Leishmania major and L. tropica among CL suspected patients referred to the Center for Research and Training in Skin Diseases and Leprosy, (CRTSDL) during 2008 to 2011 are described.
CL patients with suspected lesions were clinically examined. History of trip to zoonotic CL and/or anthroponotic CL endemic areas and the characteristics of their lesion(s) were recorded. Diagnosis of the lesion was done using direct smear microscopy, culture and conventional polymerase chain reaction (PCR).
A total of 404 (M = 256, F = 148) patients with 776 lesions were recruited and parasitologically examined. The results showed that 255 of the patients with 613 lesions; patients with lesion(s) induced by L. major=147 (M = 63, 43%, F = 84, 57%) and lesion(s) induced by L. tropica=108 (M = 35, 32%, F = 73, 68%). History of travel to endemic area was not always correlated with isolated Leishmania species.
Although travel history to endemic area is an important factor to be considered for diagnosis, but parasitological confirmation is necessary initiation of treatment.
皮肤利什曼病（CL）是伊朗许多地区的一个主要健康问题，尽管CL的诊断在流行地区尤其是容易的，但该疾病的治疗和管理是一个全球性难题。非流行地区CL的诊断不像在流行病灶中那么简单。在本研究中，描述了2008年至2011年期间转诊至皮肤病和麻风病研究与培训中心（CRTSDL）的疑似CL患者中由硕大利什曼原虫和热带利什曼原虫引起的CL的状况和比例。
对有疑似病变的CL患者进行临床检查。记录前往动物源性CL和/或人源性CL流行地区的旅行史及其病变特征。使用直接涂片显微镜检查、培养和常规聚合酶链反应（PCR）进行病变诊断。
共招募了404名（男性 = 256名，女性 = 148名）有776处病变的患者并进行了寄生虫学检查。结果显示，255名患者有613处病变；由硕大利什曼原虫引起病变的患者 = 147名（男性 = 63名，43%，女性 = 84名，57%），由热带利什曼原虫引起病变的患者 = 108名（男性 = 35名，32%，女性 = 73名，68%）。前往流行地区的旅行史并不总是与分离出的利什曼原虫种类相关。
尽管前往流行地区的旅行史是诊断时要考虑的一个重要因素，但寄生虫学确诊是开始治疗的必要条件。
