title: Papular dermatitis due to Leishmania infantum infection in seventeen dogs: diagnostic features, extent of the infection and treatment outcome.
abstract: :
  
  
  BACKGROUND
  This study describes immunological responses, diagnostic features, follow up and treatment outcomes from seventeen dogs with papular dermatitis due to Leishmania infection diagnosed by cytology or real time-PCR.
  
  
  METHODS
  Specific Leishmania humoral and cellular immune responses were evaluated by means of an immunofluorescence antibody test in all cases and a delayed-type hypersensitivity (DTH) reaction to leishmanin in eight cases. The extent of infection was studied in several tissues including blood, lymph node, conjunctival and oral swabs, by means of PCR, at the time of diagnosis and during follow-up. Culture was performed on nine dogs from cutaneous lesions and lymph node aspirates and molecular typing was carried out on isolates based on ITS-1, ITS-2 and Haspb gene sequencing analysis.
  
  
  RESULTS
  Cytological and molecular results from fine needle aspirates of papules were diagnostic in 8 out of 13 (61.5%) cases and in 14 out of 15 dogs (93.3%), respectively. In all dogs, specific anti-Leishmania antibody levels were low or absent. Blood and lymph node PCRs and lymph node culture were negative in all dogs. Three out of the nine dogs (33%) were positive by culture from cutaneous lesions. The three isolates were identified as ITS type A, however, polymorphism was observed in the Haspb gene (PCR products of 626 bp, 962 bp and 371 bp). DTH response was positive in all tested dogs at the time of diagnosis. The majority of dogs were successfully treated with only N-methylglucamine antimoniate, after which cutaneous lesions disappeared or were reduced to depigmented, flattened scars. All dogs remained seronegative and the majority of dogs were negative by PCR in several tissues during follow-up.
  
  
  CONCLUSIONS
  This study points out that papular dermatitis due to L. infantum is probably an underestimated benign cutaneous problem, associated with a parasite specific cell mediated immunity and a poor humoral immune response. Papular dermatitis is seen in young dogs, and appears to be a mild disease with restricted parasite dissemination and a good prognosis. PCR can be used as a non-invasive method to routinely evaluate papules if Leishmania infection is suspected in cases in which parasites are not visualized by cytology.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Lombardo
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Pennisi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Lupo
authors.forename: Carmen
authors.initials: C
authors.lastname: Chicharro
authors.affiliation: Departament de Medicina i Cirurgia Animal, Facultat de Veterinaria, Universitat Autònoma de Barcelona, Cerdanyola 08193 Barcelona, Spain. laia.solano@uab.cat.
authors.forename: Laia
authors.initials: L
authors.lastname: Solano-Gallego
mesh_terms: D000818:Animals; D000913:Antibodies, Protozoan / Q000276:immunology*; D000953:Antigens, Protozoan / Q000235:genetics / Q000276:immunology; D016054:DNA, Protozoan / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D003872:Dermatitis / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000662:veterinary*; D004283:Dog Diseases / Q000175:diagnosis / Q000276:immunology / Q000469:parasitology*; D004285:Dogs; D005260:Female; D018314:Leishmania infantum / Q000145:classification / Q000166:cytology / Q000276:immunology / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000662:veterinary*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D058889:Molecular Typing / Q000662:veterinary; D009942:Organometallic Compounds / Q000627:therapeutic use*; D011379:Prognosis; D015800:Protozoan Proteins / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction / Q000662:veterinary; D017422:Sequence Analysis, DNA / Q000662:veterinary; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D016054:DNA, Protozoan; D021903:DNA, Ribosomal Spacer; C401884:HASPB protein, Leishmania; D009942:Organometallic Compounds; D015800:Protozoan Proteins; C032127:leishmanin; D008536:Meglumine; D000077485:Meglumine Antimoniate