title: Montenegro skin test and age of skin lesion as predictors of treatment failure in cutaneous leishmaniasis.
abstract: A case-control study was conducted to examine the association among the Montenegro skin test (MST), age of skin lesion and therapeutic response in patients with cutaneous leishmaniasis (CL) treated at Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil. For each treatment failure (case), two controls showing skin lesion healing following treatment, paired by sex and age, were randomly selected. All patients were treated with 5 mg Sb(5+)/kg/day of intramuscular meglumine antimoniate (Sb(5+)) for 30 successive days. Patients with CL were approximately five times more likely to fail when lesions were less than two months old at the first appointment. Patients with treatment failure showed less intense MST reactions than patients progressing to clinical cure. For each 10 mm of increase in MST response, there was a 26% reduction in the chance of treatment failure. An early treatment - defined as a treatment applied for skin lesions, which starts when they are less than two months old at the first appointment -, as well as a poor cellular immune response, reflected by lower reactivity in MST, were associated with treatment failure in cutaneous leishmaniasis.
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Liliane de Fátima
authors.initials: Lde F
authors.lastname: Antonio
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Fagundes
authors.affiliation: Laboratório de Epidemiologia Clínica (Lab. EpiClin), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Raquel Vasconcellos Carvalhaes
authors.initials: RV
authors.lastname: Oliveira
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Priscila Garcia
authors.initials: PG
authors.lastname: Pinto
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Sandro Javier
authors.initials: SJ
authors.lastname: Bedoya-Pacheco
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Erica de Camargo Ferreira e
authors.initials: Ede C
authors.lastname: Vasconcellos
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Maria Cláudia
authors.initials: MC
authors.lastname: Valete-Rosalino
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Marcelo Rosandiski
authors.initials: MR
authors.lastname: Lyra
authors.affiliation: Laboratório de Epidemiologia Clínica (Lab. EpiClin), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Sônia Regina Lambert
authors.initials: SR
authors.lastname: Passos
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Maria Inês Fernandes
authors.initials: MI
authors.lastname: Pimentel
authors.affiliation: Laboratório de Vigilância em Leishmanioses (Lab VigiLeish), Instituto de Pesquisa Clínica Evandro Chagas (IPEC)/Fiocruz, Brazil.
authors.forename: Armando de Oliveira
authors.initials: Ade O
authors.lastname: Schubach
mesh_terms: D000293:Adolescent; D000328:Adult; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007428:Intradermal Tests / Q000379:methods*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate