Clinical diversity and treatment results in Tegumentary Leishmaniasis: a European clinical report in 459 patients.
Author
Guery, RomainWalker, Stephen L
Harms, Gundel
Neumayr, Andreas
Van Thiel, Pieter
Gangneux, Jean-Pierre
Clerinx, Jan
Söbirk, Sara Karlsson
Visser, Leo
Lachaud, Laurence
Bailey, Mark
Bart, Aldert
Ravel, Christophe
Van der Auwera, Gert
Blum, Johannes
Lockwood, Diana N
Buffet, Pierre
Publication date
2021-10-13Subject
DermatologyPublic health. Health statistics. Occupational health. Health education
Microbiology. Immunology
Metadata
Show full item recordAbstract
Background: Cutaneous leishmaniasis (CL) is frequent in travellers and can involve oro-nasal mucosae. Clinical presentation impacts therapeutic management. Methodology: Demographic and clinical data from 459 travellers infected in 47 different countries were collected by members of the European LeishMan consortium. The infecting Leishmania species was identified in 198 patients. Principal findings: Compared to Old World CL, New World CL was more frequently ulcerative (75% vs 47%), larger (3 vs 2cm), less frequently facial (17% vs 38%) and less frequently associated with mucosal involvement (2.7% vs 5.3%). Patients with mucosal lesions were older (58 vs 30 years) and more frequently immunocompromised (37% vs 3.5%) compared to patients with only skin lesions. Young adults infected in Latin America with L. braziliensis or L. guyanensis complex typically had an ulcer of the lower limbs with mucosal involvement in 5.8% of cases. Typically, infections with L. major and L. tropica acquired in Africa or the Middle East were not associated with mucosal lesions, while infections with L. infantum, acquired in Southern Europe resulted in slowly evolving facial lesions with mucosal involvement in 22% of cases. Local or systemic treatments were used in patients with different clinical presentations but resulted in similarly high cure rates (89% vs 86%). Conclusion/significance: CL acquired in L. infantum-endemic European and Mediterranean areas displays unexpected high rates of mucosal involvement comparable to those of CL acquired in Latin America, especially in immunocompromised patients. When used as per recommendations, local therapy is associated with high cure rates.Citation
Guery R, Walker SL, Harms G, Neumayr A, Van Thiel P, Gangneux JP, Clerinx J, Söbirk SK, Visser L, Lachaud L, Bailey M, Bart A, Ravel C, Van der Auwera G, Blum J, Lockwood DN, Buffet P; LeishMan Network and the French Cutaneous Leishmaniasis Study group. Clinical diversity and treatment results in Tegumentary Leishmaniasis: A European clinical report in 459 patients. PLoS Negl Trop Dis. 2021 Oct 13;15(10):e0009863. doi: 10.1371/journal.pntd.0009863Type
ArticleAdditional Links
https://journals.plos.org/plosntds/PMID
34644288Journal
PLoS Neglected Tropical DiseasesPublisher
Public Library of Scienceae974a485f413a2113503eed53cd6c53
10.1371/journal.pntd.0009863