Clinical and epidemiologic features of cutaneous leishmaniosis in Medellín

Abstract

Cutaneous and mucocutaneous leishmaniosis are endemic in most of the Colombian territory; the visceral form has been detected in some areas. At the Leishmanlosis Service, University of Antioquia, School of Medicine, we evaluated the clinical and epidemiologic features of 169 patients with proven leishmanlosis, diagnosed between 1986 and 1988. Diagnostic tests included: direct examination, cultures, biopsies, indirect immunofluorescent stain and Montenegro's test. There were 118 men (69.8%) and 51 women (30.2%); two thirds of the patients were between 15 and 44 years-old; most of them carne from the northwestern part of Colombia. There was striking clinical polymorphism of the lesions; only 13 patients (7.7%) had mucous involvement. Positivity rate of the diagnostic tests was as follows: direct examination 65.8%, culture 58.7%, biopsy 51.8%, indirect immunofluorescent stain 68.0%, Montenegro's test 95.5%. We call on the attention to some other Important aspects, namely: frequency of previous lesions similar to the present ones, use of nonspecific treatments and the need of an Increased clinical suspicion in patient’s with cutaneous lesions lasting for more than one month.