Kibbi A G, Karam P G, Kurban A K
Department of Dermatology, American University of Beirut Medical Center, Lebanon.
J Am Acad Dermatol. 1987 Nov;17(5 Pt 1):759-64. doi: 10.1016/s0190-9622(87)70259-x.
The clinical and pathologic presentations of cutaneous leishmaniasis in the various countries of the Middle East are well documented. The defined patterns currently encountered in the region emphasize the rarity of local extension of the infection from the bite site. Between 1970 and 1980 we have seen 24 patients with cutaneous leishmaniasis who acquired the infection in Saudi Arabia. In these patients there were several interesting variations from the hitherto described patterns of Oriental sore. The variations include, clinically, the appearance of satellite lesions and the presence of sporotrichoid spread of infection; and histologically, the presence of stellate intradermal abscesses. Such variations in the clinical and pathologic presentations may be due to differences either in the host's immunologic reactivity or in the Leishmania organisms found in Saudi Arabia. Speculative evidence supports the possibility of a different strain and/or species of Leishmania tropica in Saudi Arabia, which in turn may be responsible for this unique clinicopathologic presentation.
中东各国皮肤利什曼病的临床和病理表现已有充分记录。该地区目前所见到的明确模式强调了感染从叮咬部位局部扩散的罕见性。1970年至1980年间，我们诊治了24例在沙特阿拉伯感染皮肤利什曼病的患者。在这些患者中，与迄今所描述的东方疖模式存在一些有趣的差异。这些差异在临床上包括卫星病灶的出现和感染的孢子丝菌样扩散；在组织学上包括星状真皮内脓肿的存在。临床和病理表现的这种差异可能是由于宿主免疫反应性的差异或沙特阿拉伯发现的利什曼原虫生物体的差异。推测性证据支持沙特阿拉伯存在不同菌株和/或热带利什曼原虫物种的可能性，这反过来可能是这种独特临床病理表现的原因。
