title: The natural history of cutaneous leishmaniasis in Guatemala.
abstract: The natural history of American cutaneous leishmaniasis was studied in Guatemala by analyzing the characteristics of 355 untreated leishmanial lesions, observing the evolution of 57 lesions on persons who received a placebo in treatment trials, and analyzing data from a population-based survey concerning the duration of 82 untreated lesions. Of 25 lesions caused by Leishmania mexicana that were followed prospectively, 22 (88%) completely reepithelialized by a median lesion age of 14 weeks, and 17 (68%) were classified as cured (no residual wound inflammation or reactivation during at least 6 months of follow-up). In contrast, 7 (22%) of 32 lesions caused by Leishmania braziliensis reepithelialized by a median lesion age of 13 weeks, and only 2 (6%) cured. These data demonstrate that the species of Leishmania is the primary determinant of the clinical course and outcome of untreated lesions and underscore the need for field-applicable diagnostic techniques that provide rapid species identification.
authors.affiliation: Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
authors.forename: B L
authors.initials: BL
authors.lastname: Herwaldt
authors.forename: B A
authors.initials: BA
authors.lastname: Arana
authors.forename: T R
authors.initials: TR
authors.lastname: Navin
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004431:Ear, External; D005260:Female; D005500:Follow-Up Studies; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007892:Leishmania braziliensis / Q000502:physiology*; D007894:Leishmania mexicana / Q000502:physiology*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000473:pathology*