Hashim F A, Elhassan A M
Physiology Department, Faculty of Medicine, University of Khartoum, Sudan.
Int J Dermatol. 1994 Apr;33(4):258-9. doi: 10.1111/j.1365-4362.1994.tb01038.x.
Visceral leishmaniasis (VL) is endemic in several areas in the Sudan. The disease is associated with depressed cellular immunity. Tinea versicolor is a normal commensal of the skin which can become pathogenic particularly in patients with depressed cell-mediated immunity. Patients with VL have a high prevalence of tinea versicolor.
One hundred and thirty patients with parasitologic confirmation of VL were screened for tinea versicolor infection. In the suspected cases the diagnosis was made by demonstrating the fungal hyphae and spores in skin scrapings. All patients were treated with sodium stibogluconate.
Of the 130 patients with VL, 10.8% were found to have severe tinea versicolor. The fungal infection developed or became worse with the start of VL. After successful treatment of VL, the tinea lesions disappeared completely or decreased in severity.
Depressed cell-mediated immunity that is a feature of VL is the probable underlying cause for fungal infection. Tinea infection during the course of VL is to be distinguished from lesions of post-kala-azar dermal leishmaniasis.
内脏利什曼病（VL）在苏丹的多个地区呈地方性流行。该疾病与细胞免疫功能低下有关。花斑癣是皮肤的一种正常共生菌，尤其在细胞介导免疫功能低下的患者中可成为致病菌。VL患者中花斑癣的患病率很高。
对130例经寄生虫学确诊的VL患者进行花斑癣感染筛查。在疑似病例中，通过在皮肤刮片中发现真菌菌丝和孢子来做出诊断。所有患者均接受葡萄糖酸锑钠治疗。
在130例VL患者中，发现10.8%患有重度花斑癣。真菌感染随着VL的开始而出现或加重。VL成功治疗后，花斑癣皮损完全消失或严重程度减轻。
VL的特征性细胞介导免疫功能低下可能是真菌感染的潜在根本原因。VL病程中的花斑癣感染需与黑热病后皮肤利什曼病的皮损相鉴别。
