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Abstract
Visceral leishmaniasis (VL) is endemic in Northwest and southern Iran. Reports of cutaneous leishmaniasis (CL) in Northwest areas are rare, and its etiological agents are unknown. In the current study, we report six CL and two post kala-azar dermal leishmaniasis (PKDL) cases caused by Leishmania infantum from endemic areas of VL in the Northwest. Smears were made from skin lesions of 30 suspected patients in 2002–2011, and CL was determined by microscopy or culture. Leishmania spp. were identified by nested-PCR assay. The disease was confirmed in 20 out of 30 (66%) suspected patients by parasitological examinations. L. infantum was identified in eight and Leishmania major in 12 CL cases by nested-PCR. Cutaneous leishmaniasis patients infected with L. major had the history of travel to CL endemic areas. L. infantum antibodies were detected by direct agglutination test (DAT) at titers of 1:3200 in two cases with history of VL. Results of this study indicated that L. infantum is a causative agent of CL as well as PKDL in the VL endemic areas.
This study received financial support from Tehran University of Medical Sciences (Project No: 89-04-27-11828) and also National Institute of Health Research (NIHR), Islamic Republic of Iran (Meshkin-Shahr research station). The present work was a part of MSc thesis. We wish to thank Dr MM Gooya and Dr MR Shirzadi from the Center of Communicable Diseases Control, Ministry of Health, Treatment and Medical Education, Tehran, Iran. We thank Dr F Pourfarzi, Dr Barak, Mr Rafei from Ardabil University of Medical Sciences, as well as Mrs N Mirsamadi from the East Azerbaijan Health Centre and Mrs S Charehdar from the Leishmaniasis laboratory at the School of Public Health, Tehran University of Medical Sciences.