RESUMEN
Mucosal leishmaniasis (ML) is often clinically silent until reaching a highly advanced state. In this prospective study, 6 of 220 patients with early cutaneous leishmaniasis were diagnosed with mucosal involvement by otorhinolaryngological examination (a rate similar to the reported rate of late ML). Detection of early ML may represent an important strategy in preventing severe mucosal destruction in human leishmaniasis.
Asunto(s)
Leishmaniasis Cutánea/complicaciones , Leishmaniasis Mucocutánea/complicaciones , Leishmaniasis Mucocutánea/diagnóstico , Adolescente , Adulto , Anciano , Animales , Anticuerpos Antiprotozoarios/sangre , Brasil , Endoscopía/métodos , Femenino , Humanos , Leishmaniasis Cutánea/diagnóstico , Masculino , Persona de Mediana Edad , Mucosa Nasal/parasitología , Mucosa Nasal/patología , Estudios Prospectivos , Pruebas Cutáneas/métodosRESUMEN
Cutaneous leishmaniasis (CL) is a worldwide disease endemic in several regions of the globe. The hallmark of CL is skin ulcers likely driven by efforts of the immune system to control Leishmania growth. Cytokines, such as tumor necrosis factor (TNF) and interferon-gamma can control disease progression in animal models. Nevertheless, the impact of these cytokines in CL ulcer outcome is not well established in humans. In this study, 96 CL patients from an endemic area of Leishmania braziliensis were enrolled for a follow-up study that consisted of clinical and immunological evaluations in a 2-year period. Statistical analysis revealed that healing time (P = 0.029), age (P = 0.002), and TNF levels (P = 0.0002) positively correlate with ulcer size at the time of the first clinical evaluation. Our findings suggest that ulcer size correlates with healing time and TNF levels support the use of TNF inhibitors combined with standard therapy to improve healing in CL patients with severe lesions.