Momeni A Z, Aminjavaheri M
Department of Dermatology, Isfahan University of Medical Sciences, Iran.
Int J Dermatol. 1994 Apr;33(4):260-5. doi: 10.1111/j.1365-4362.1994.tb01039.x.
Cutaneous leishmaniasis caused by Leishmania tropica is endemic in Iran, being the second most prevalent vector-borne disease in the country (after malaria). From the five most infected provinces, Isfahan is third after Boushehr and Khouzestan.
To study the clinical picture of this disease, 1250 patients referred to the Leishmaniasis Training and Treatment Center (affiliated with Isfahan University of Medical Sciences) were studied during a 2-year period.
The disease was more prevalent in the age group of 10-15 years. Nonindigenes had more lesions and their lesions were more acute and more severe than those of indigenes. The face was the most frequent site of involvement (39.7%), followed by the upper (32.4%) and lower extremities (19.4%), whereas only 8.1% of the lesions were found on the trunk. No direct relation was seen with age, sex, and clinical features of the lesions except for the erysipeloid cases that were rare and seen only in middle-aged and elderly women. Noduloulcerative and papular lesions dominated the clinical picture, followed by plaque, impetiginized, and nodular lesions.
The reason why nonindigenous patients have more severe lesions and in greater number is not clear. It can be postulated that nonindigenous people were more exposed to the vector biting since they were living in more infected areas and that during a long period of time, a mild immunity might have developed in indigenous people.
热带利什曼原虫引起的皮肤利什曼病在伊朗呈地方性流行，是该国第二大最普遍的媒介传播疾病（仅次于疟疾）。在五个感染最严重的省份中，伊斯法罕排在布什尔和胡齐斯坦之后位列第三。
为研究该疾病的临床表现，在两年时间里对转诊至利什曼病培训与治疗中心（隶属于伊斯法罕医科大学）的1250名患者进行了研究。
该疾病在10 - 15岁年龄组中更为普遍。非本地居民的皮损更多，且他们的皮损比本地居民的更急性、更严重。面部是最常受累部位（39.7%），其次是上肢（32.4%）和下肢（19.4%），而仅有8.1%的皮损出现在躯干。除丹毒样病例罕见且仅见于中老年女性外，未发现与皮损的年龄、性别及临床特征有直接关系。临床症状以结节溃疡性和丘疹性皮损为主，其次是斑块状、脓疱化和结节性皮损。
非本地患者有更严重且数量更多的皮损的原因尚不清楚。可以推测，非本地居民由于生活在感染更严重的地区而更多地暴露于媒介叮咬，并且在很长一段时间里，本地居民可能已形成了轻度免疫力。
