Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
Department of Microbiology, College of Arts and Sciences, The Ohio State University, Columbus, OH, United States.
Front Cell Infect Microbiol. 2021 Jun 8;11:685296. doi: 10.3389/fcimb.2021.685296. eCollection 2021.
Leishmaniasis is a neglected tropical disease that affects 12 million people worldwide. The disease has high morbidity and mortality rates and is prevalent in over 80 countries, leaving more than 300 million people at risk of infection. Of all of the manifestations of this disease, cutaneous leishmaniasis (CL) is the most common form and it presents as ulcerating skin lesions that can self-heal or become chronic, leading to disfiguring scars. This review focuses on the different pathologies and disease manifestations of CL, as well as their varying degrees of severity. In particular, this review will discuss self-healing localized cutaneous leishmaniasis (LCL), leishmaniasis recidivans (LR), mucocutaneous leishmaniasis (MCL), anergic diffuse cutaneous leishmaniasis (ADCL), disseminated leishmaniasis (DL), and Post Kala-azar Dermal Leishmaniasis (PKDL), which is a cutaneous manifestation observed in some visceral leishmaniasis (VL) patients after successful treatment. The different clinical manifestations of CL are determined by a variety of factors including the species of the parasites and the host's immune response. Specifically, the balance between the pro and anti-inflammatory mediators plays a vital role in the clinical presentation and outcome of the disease. Depending upon the immune response, infection can also transition from one form of the disease to another. In this review, different forms of cutaneous infections and their immunology are described.
利什曼病是一种被忽视的热带病,影响全球 1200 万人。这种疾病的发病率和死亡率都很高,在 80 多个国家流行,超过 3 亿人面临感染风险。在这种疾病的所有表现中,皮肤利什曼病(CL)最为常见,其表现为溃疡性皮肤损伤,可自行愈合或转为慢性,导致毁容性疤痕。本综述重点介绍了 CL 的不同病理学和疾病表现,以及它们的严重程度不同。特别是,本综述将讨论自限性局部皮肤利什曼病(LCL)、复发性利什曼病(LR)、黏膜皮肤利什曼病(MCL)、无反应性弥漫性皮肤利什曼病(ADCL)、播散性利什曼病(DL)和 Kala-azar 后皮肤利什曼病(PKDL),这是一些内脏利什曼病(VL)患者在成功治疗后观察到的皮肤表现。CL 的不同临床表现是由多种因素决定的,包括寄生虫的种类和宿主的免疫反应。具体来说,促炎和抗炎介质之间的平衡在疾病的临床表现和结果中起着至关重要的作用。根据免疫反应,感染也可以从一种疾病形式转变为另一种疾病形式。在本综述中,描述了不同形式的皮肤感染及其免疫学。
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