Oliveira-Neto M P, Mattos M, Souza C S, Fernandes O, Pirmez C
Hospital Evandro Chagas, Departamento de Protozoologia, Instituto Oswaldo Cruz (IOC), and FIOCruz, Rio de Janeiro, Brazil.
Int J Dermatol. 1998 Nov;37(11):846-9. doi: 10.1046/j.1365-4362.1998.00478.x.
Leishmaniasis recidiva cutis (LRC) is rare in New World leishmaniasis. Only seven cases have been reported so far.
Four cases are reported here. Parasite diagnosis was performed by classical methods of touch preparations, histopathologic sections, and cultures. In addition, the detection of parasite DNA by the polymerase chain reaction (PCR) was performed in all cases.
Parasites were detected by at least one of the classical methods in all primary lesions; however, only the PCR was positive in the recidivant lesions.
LRC cases most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in scarred tissue. Although lupoid leishmaniasis (LL) has been used as a synonym of LRC, a clear difference between LRC and LL can be defined as LL is the initial clinical presentation while LRC is a recurrent lesion.
The results indicate that it is not appropriate to use these two denominations as synonyms. The designation of LRC should be maintained in order to define recidives occurring at the border of an old scar of cutaneous leishmaniasis, avoiding the confusion with the lupoid form of the disease.
皮肤利什曼病复发型（LRC）在新大陆利什曼病中较为罕见。迄今为止，仅报道过7例。
本文报道4例。通过触片、组织病理学切片和培养等经典方法进行寄生虫诊断。此外，所有病例均采用聚合酶链反应（PCR）检测寄生虫DNA。
在所有原发性皮损中，至少通过一种经典方法检测到了寄生虫；然而，在复发皮损中只有PCR呈阳性。
LRC病例很可能代表初始感染的再激活，可能是由于寄生虫在瘢痕组织中持续存在。尽管类狼疮样利什曼病（LL）一直被用作LRC的同义词，但LRC和LL之间的明显差异可以定义为LL是初始临床表现，而LRC是复发性皮损。
结果表明，将这两个名称用作同义词是不合适的。应保留LRC的名称，以定义在皮肤利什曼病旧瘢痕边缘出现的复发情况，避免与该病的类狼疮形式相混淆。
