Post-kala-azar Dermal Leishmaniasis 中的生物标志物。
Biomarkers in Post-kala-azar Dermal Leishmaniasis.
机构信息
Rotterdam Centre for Tropical Medicine, Rotterdam, Netherlands.
出版信息
Front Cell Infect Microbiol. 2019 Jul 31;9:228. doi: 10.3389/fcimb.2019.00228. eCollection 2019.
Post-kala-azar dermal leishmaniasis (PKDL) follows visceral leishmaniasis (VL, kala-azar) in 10-60% of cases. It is characterized by an asymptomatic skin rash, usually starting in the face and consisting of macules, papules, or nodules. Diagnosis is difficult in the field and is often made clinically. There is an extensive differential diagnosis, and parasitological confirmation is preferred particularly when drug treatment is considered. The response to treatment is difficult to assess as this may be slow and lesions take long to heal, thus possibly exposing patients unnecessarily to prolonged drug treatment. Biomarkers are needed; these may be parasitological (from microscopy, PCR), serological (from blood, or from the lesion), immunological (from blood, tissue), pathological (from cytology in a smear, histology in a biopsy), repeated clinical assessment (grading, photography), or combinations. In this paper, we will review evidence for currently used biomarkers and discuss promising developments.
Post-kala-azar dermal leishmaniasis (PKDL) follows visceral leishmaniasis (VL, kala-azar) in 10-60% of cases. It is characterized by an asymptomatic skin rash, usually starting in the face and consisting of macules, papules, or nodules. Diagnosis is difficult in the field and is often made clinically. There is an extensive differential diagnosis, and parasitological confirmation is preferred particularly when drug treatment is considered. The response to treatment is difficult to assess as this may be slow and lesions take long to heal, thus possibly exposing patients unnecessarily to prolonged drug treatment. Biomarkers are needed; these may be parasitological (from microscopy, PCR), serological (from blood, or from the lesion), immunological (from blood, tissue), pathological (from cytology in a smear, histology in a biopsy), repeated clinical assessment (grading, photography), or combinations. In this paper, we will review evidence for currently used biomarkers and discuss promising developments.
皮肤利什曼病（PKDL）是内脏利什曼病（VL，黑热病）的后续病症，在 10%-60%的病例中出现。它的特征是无症状的皮疹，通常从面部开始，由斑疹、丘疹或结节组成。在现场诊断较为困难，通常通过临床诊断。该病有广泛的鉴别诊断，特别是在考虑药物治疗时，寄生虫学确认是首选。由于治疗反应可能缓慢，病变需要很长时间才能愈合，因此患者可能会不必要地接受长期药物治疗，因此治疗反应难以评估。需要生物标志物；这些标志物可以是寄生虫学的（来自显微镜、PCR）、血清学的（来自血液或病变）、免疫学的（来自血液、组织）、病理学的（来自涂片的细胞学、活检的组织学）、重复的临床评估（分级、摄影）或组合。在本文中，我们将回顾目前使用的生物标志物的证据，并讨论有前途的发展。
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