Azambuja R, Sampaio R N, Marsden P D
Hautarzt. 1985 Sep;36(9):531-3.
Mucocutaneous leishmaniasis has a large incidence in Brazil. Biochemical, immunological and biological studies have characterized three disease agents: Leishmania mexicana amazonensis, Leishmania brasiliensis guyanensis and Leishmania brasiliensis brasiliensis; these have distinct geographical distributions. The last one is the most common and is the most difficult to treat. Destructive mucosal lesions can occur days, months or years after the cutaneous lesions. The Montenegro intradermal test, biopsy, smears of the border of ulcers and indirect immunofluorescence are the auxiliary diagnostic methods currently in use. The only effective drugs for the treatment of this disease are pentavalent antimonials and amphotericin B. After clinical cure, relapses can occur, and there are rare cases with mucosal lesions that are resistant to all forms of treatment.
皮肤黏膜利什曼病在巴西发病率很高。生化、免疫和生物学研究已鉴定出三种致病原：亚马逊利什曼原虫、圭亚那利什曼原虫和巴西利什曼原虫；它们具有不同的地理分布。最后一种最为常见且最难治疗。破坏性黏膜病变可在皮肤病变数天、数月或数年后出现。蒙氏皮内试验、活检、溃疡边缘涂片及间接免疫荧光是目前常用的辅助诊断方法。治疗该病的唯一有效药物是五价锑剂和两性霉素B。临床治愈后可能会复发，并且存在罕见的对所有治疗形式均耐药的黏膜病变病例。
