title: Cutaneous scars in American tegumentary leishmaniasis patients: a site of Leishmania (Viannia) braziliensis persistence and viability eleven years after antimonial therapy and clinical cure.
abstract: Two former patients treated for the cutaneous form of American tegumentary leishmaniasis were reviewed eight and 11 years, respectively, following clinical cure. We were able to isolate Leishmania parasites in a culture of material from the two scar biopsies, and in one of them the parasite was characterized as Leishmania (Viannia) braziliensis. In both cases, the histopathology revealed discreet hyperceratosis and a slight infiltrate of mononuclear cells surrounding and on the walls of the surface and deep dermal vessels. No amastigotes were seen on immunohistochemical or histopathologic examination. The Montenegro skin test result and the in vitro lymphoproliferative response to Leishmania antigen were positive, but no specific IgG and IgM antibodies were detected. Otorhinolaryngologic examination showed no macroscopic alteration in the mucosae. These findings are important for the evaluation and criteria of post-treatment cure.
authors.affiliation: Hospital Evandro Chagas, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Schubach
authors.forename: M C
authors.initials: MC
authors.lastname: Marzochi
authors.forename: T
authors.initials: T
authors.lastname: Cuzzi-Maya
authors.forename: A V
authors.initials: AV
authors.lastname: Oliveira
authors.forename: M L
authors.initials: ML
authors.lastname: Araujo
authors.forename: A L
authors.initials: AL
authors.lastname: Oliveira
authors.forename: R S
authors.initials: RS
authors.lastname: Pacheco
authors.forename: H
authors.initials: H
authors.lastname: Momen
authors.forename: F
authors.initials: F
authors.lastname: Conceicao-Silva
authors.forename: S G
authors.initials: SG
authors.lastname: Coutinho
authors.forename: K B
authors.initials: KB
authors.lastname: Marzochi
mesh_terms: D000328:Adult; D000818:Animals; D001706:Biopsy; D002921:Cicatrix / Q000469:parasitology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007892:Leishmania braziliensis / Q000302:isolation & purification / Q000502:physiology*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use
chemical_list: D008536:Meglumine