Studies on chronic (lupoid) leishmaniasis

Abstract

Eighteen leishmaniasis cases were diagnosed as lupoid because the duration of their disease varied from 1·5 to eight years and the diameter of the lesion varied from 1 cm to 6 cm. In smears prepared from exudates of the lesions amastigotes were observed only once. No organisms were recovered in cultures from biopsy material from eight cases. Histological studies showed that small lymphocytes were always present but plasma cells never formed a prominent component of the inflammatory response. Histiocytic granulomas, with or without giant cells, were seen. No acid-fast organisms were demonstrated. Fifteen out of 16 cases skin-tested with leishmanin demonstrated strongly positive delayed type hypersensitivity. However, when these 15 patients were skin tested with PPD only three showed positive skin reactivity. Only four patients had IFAT antibody titres in excess of 1 /32.