Khatri Mishri Lal, Di Muccio Trentina, Fiorentino Eleonora, Gramiccia Marina
Department of Dermatology, Saudi Hospital at Hajjah, Hajjah, Yemen.
Unit of Vector-borne Diseases and International Health, Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
Int J Dermatol. 2016 Nov;55(11):1210-1218. doi: 10.1111/ijd.13310.
Cutaneous leishmaniasis (CL) is widespread in Yemen but has not been fully documented.
This study aimed to investigate the clinicoepidemiologic and geographic aspects of CL in northwest Yemen and the taxonomic profile of the causative Leishmania species.
All CL cases diagnosed at the Dermatology Clinic of the Saudi Hospital at Hajjah during 1997-2012 were reviewed. Diagnoses were based on clinical, microscopic and, occasionally, histopathologic examinations. Leishmania species identification was carried out in 712 microscopically positive samples by multi-locus enzyme electrophoresis and polymerase chain reaction-restriction fragment length polymorphism.
During the surveillance period, 1343 cases of CL were diagnosed. Lesions per patient ranged from one to 71, but most patients had a single facial lesion, classified as representing the "dry type" in 1315 (97.9%) and "wet type" in 28 (2.1%) patients. Leishmania typing in 576 cases identified Leishmania tropica as the main species responsible (n = 529), followed by Leishmania infantum (n = 20), Leishmania donovani (n = 11), and members of the L. donovani complex (n = 8). Atypical molecular patterns were observed in eight CL cases diagnosed in areas in which the three Leishmania species were found sympatrically.
Cutaneous leishmaniasis appears to be endemic in northwest Yemen, where its incidence has recently increased abruptly. The disease presents clinically as the "dry type" and is caused mainly by L. tropica and occasionally by L. infantum, L. donovani, and L. donovani complex species. A sympatric diffusion of the three species is present in some governorates.
皮肤利什曼病（CL）在也门广泛流行，但尚未得到充分记录。
本研究旨在调查也门西北部CL的临床流行病学和地理特征以及致病利什曼原虫物种的分类概况。
回顾了1997年至2012年期间在哈杰沙特医院皮肤科诊所诊断的所有CL病例。诊断基于临床、显微镜检查，偶尔也包括组织病理学检查。通过多位点酶电泳和聚合酶链反应-限制性片段长度多态性对712份显微镜检查呈阳性的样本进行利什曼原虫物种鉴定。
在监测期间，共诊断出1343例CL病例。每位患者的皮损数量从1个到71个不等，但大多数患者有单个面部皮损，其中1315例（97.9%）分类为“干燥型”，28例（2.1%）为“湿润型”。对576例病例进行的利什曼原虫分型显示，主要致病物种为热带利什曼原虫（n = 529）, 其次是婴儿利什曼原虫（n = 20）、杜氏利什曼原虫（n = 11）以及杜氏利什曼原虫复合体成员（n = 8）。在三个利什曼原虫物种同域分布地区诊断的8例CL病例中观察到非典型分子模式。
皮肤利什曼病在也门西北部似乎为地方病，其发病率最近急剧上升。该疾病临床上表现为“干燥型”，主要由热带利什曼原虫引起，偶尔由婴儿利什曼原虫、杜氏利什曼原虫和杜氏利什曼原虫复合体物种引起。在一些省份存在这三个物种的同域扩散现象。
