Molecular Biology Laboratory, ICMR-National Institute of Pathology, Safdarjung Hospital Campus, New Delhi, India.
Department of Dermatology & STD, Safdarjang Hospital & VMMC, New Delhi, India.
Indian J Dermatol Venereol Leprol. 2023;90(1):78-84. doi: 10.25259/IJDVL_1017_2022.
Background Increasing urbanisation has led to the occurrence of cutaneous leishmaniasis (CL) in new areas, which was otherwise localised to endemic areas. Healthcare workers should be made aware of this entity to ensure clinical suspicion of CL and investigations needed to confirm CL. The article describes patients seen at a tertiary hospital in Delhi. Aims To establish the utility of the CL Detect Rapid test as a diagnostic tool and the efficacy of Liposomal Amphotericin B (LAmB) for the complete cure of CL patients. Methods Data of patients of CL (n = 16) was retrospectively analysed concerning diagnosis and treatment. Diagnosis rested on histopathology, real-time PCR, and CL Detect Rapid Test. Speciation of the parasite was based on the Internal transcribed spacer-I gene. Patients were treated with LAmB (i.v., 5 mg/kg up to three doses, five days apart). Results A positivity of 81.3% (95%CI, 54.4-96) was observed for CL Detect Rapid test in comparison with 100% (95%CI, 79.4-100.0) for real-time PCR and 43.8% (95%CI, 19.8-70.1) for microscopy/histopathological examination. L. tropica was the infective species in all cases. All the patients treated with LAmB responded to treatment, and 9/10 patients demonstrated complete regression of lesions, while one was lost to follow-up. Limitations It is a retrospective study, and the data includes only confirmed cases of CL at a single centre. Conclusion This study highlights the utility of CL Detect as a promising diagnostic tool and the efficacy of LAmB for the complete cure of CL.
背景 城市化的不断发展导致皮肤利什曼病（CL）在新地区出现，而这些新地区原本为地方性流行区。医疗保健工作者应意识到这一实体，以确保对 CL 的临床怀疑，并进行必要的调查以确诊 CL。本文描述了在德里一家三级医院就诊的患者。目的 确定 CL Detect 快速检测作为一种诊断工具的效用，以及脂质体两性霉素 B（LAmB）对完全治愈 CL 患者的疗效。方法 回顾性分析了 16 例 CL 患者的诊断和治疗数据。诊断依据为组织病理学、实时 PCR 和 CL Detect 快速检测。寄生虫的种系分类基于内部转录间隔区-I 基因。患者接受 LAmB（静脉注射，5mg/kg，最多 3 剂，每剂相隔 5 天）治疗。结果 CL Detect 快速检测的阳性率为 81.3%（95%CI，54.4-96），与实时 PCR 的 100%（95%CI，79.4-100.0）和显微镜/组织病理学检查的 43.8%（95%CI，19.8-70.1）相比具有更高的敏感性。所有病例均为 L. tropica 感染。所有接受 LAmB 治疗的患者均对治疗有反应，9/10 例患者的病变完全消退，1 例失访。局限性 这是一项回顾性研究，数据仅包括单一中心确诊的 CL 病例。结论 本研究强调了 CL Detect 作为一种有前途的诊断工具的效用，以及 LAmB 对完全治愈 CL 的疗效。
