title: Cutaneous leishmaniasis in North-Western Yemen: a clinicoepidemiologic study and Leishmania species identification by polymerase chain reaction-restriction fragment length polymorphism analysis.
abstract: BACKGROUND
  Cutaneous leishmaniasis (CL) is widespread in Yemen, but not fully documented.
  
  
  OBJECTIVE
  To study the clinicoepidemiologic profile of CL in the northwestern region of Yemen Republic and to identify the responsible Leishmania species by molecular methods.
  
  
  METHODS
  All 265 CL cases (176 males and 89 females) were subjected to detailed analysis. Diagnosis was based on clinical features, positive slit skin smear, and histopathologic findings in some cases. In 198 cases, positive smears were examined at the Leishmania Reference Centre of Istituto Superiore di Sanità, Rome (Italy), by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis for Leishmania typing.
  
  
  RESULTS
  All patients were Yemeni nationals, originated from 10 governorates of northwestern Yemen. Most of the patients had a single noduloulcerative lesion on the face suggestive of "dry"-type CL. Slit skin smear was positive in 255 cases (96.23%). Leishmania sp PCR was positive in all 198 cases examined; the RFLP analysis was positive in 155 samples with the following identification results: L. tropica in 133 cases (85.80%), L. infantum in 17 (10.97%), and L. donovani in 5 (3.23%).
  
  
  CONCLUSIONS
  This was a prospective study of CL cases at one center only; hence, the full extent of the disease in the entire region cannot be predicted.
  
  
  CONCLUSIONS
  CL appears to be endemic in northwestern region of Yemen, clinically presenting as 'dry' type, caused mainly by L. tropica (85.8% of cases) and occasionally by L. infantum (10.97%) and L. donovani (3.23%). There is a need for a multicenter study to evaluate the extent of the disease and diffusion of each Leishmania responsible species.
authors.affiliation: Department of Dermatology, Saudi Hospital at Hajjah, Sana'a, Yemen Republic. mishrik1@yahoo.co.in
authors.forename: Mishri Lal
authors.initials: ML
authors.lastname: Khatri
authors.forename: Trentina
authors.initials: T
authors.lastname: Di Muccio
authors.forename: Marina
authors.initials: M
authors.lastname: Gramiccia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D007223:Infant; D007891:Leishmania / Q000235:genetics* / Q000302:isolation & purification*; D007893:Leishmania donovani / Q000235:genetics / Q000302:isolation & purification; D018314:Leishmania infantum / Q000235:genetics / Q000302:isolation & purification; D007895:Leishmania tropica / Q000235:genetics / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D015006:Yemen / Q000453:epidemiology; D055815:Young Adult