title: Unexpected co-detection of promastigote and amastigote Leishmania forms in a human cutaneous lesion: implications for leishmaniasis physiopathology and treatment.
abstract: Cutaneous leishmaniasis pathogenicity depends on the survival and replication of the parasitic protozoa in the form of non-motile amastigotes inside macrophages. Here, we report the unprecedented observation of both Leishmania major amastigote and promastigote forms (the latter is normally detected only in the mid gut of the insect vector or in vitro culture) in a cutaneous lesion of a 6-year-old boy. This finding suggests that modifications of the skin lesion environment, such as maceration and changes in pH or temperature, could promote the in situ transformation of Leishmania amastigotes into promastigotes. This observation raises questions about the physiopathology of cutaneous leishmaniasis and the influence of micro-environmental changes on the efficiency of topical treatments.
authors.affiliation: Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia. Electronic address: najoua.h@laposte.net.
authors.forename: Najoua
authors.initials: N
authors.lastname: Haouas
authors.affiliation: Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia.
authors.forename: Latifa
authors.initials: L
authors.lastname: Remadi
authors.affiliation: Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia.
authors.forename: Dhekra
authors.initials: D
authors.lastname: Chaara
authors.affiliation: Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia.
authors.forename: Najla
authors.initials: N
authors.lastname: Chargui
authors.affiliation: Hôpital Régional de Nasrallah, Kairouan, Tunisia.
authors.forename: Radhia
authors.initials: R
authors.lastname: Dabghi
authors.affiliation: Centre d'Hygiène et des Soins de Santé de Base de Kairouan, Tunisia.
authors.forename: Henda
authors.initials: H
authors.lastname: Jbeniani
authors.affiliation: Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia.
authors.forename: Hamouda
authors.initials: H
authors.lastname: Babba
authors.affiliation: French Reference Centre on Leishmaniasis, UMR5290 MIVEGEC, University of Montpellier, Department of Parasitology, Montpellier, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Ravel
mesh_terms: D000287:Administration, Topical; D001623:Betamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D005672:Fusidic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006863:Hydrogen-Ion Concentration; D018320:Leishmania major / Q000472:pathogenicity* / Q000502:physiology*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000469:parasitology* / Q000473:pathology*; D008297:Male; D014416:Tunisia
chemical_list: D005672:Fusidic Acid; D001623:Betamethasone
keywords: Cutaneous lesion; Leishmania promastigote; Maceration; Physiopathology