Localized cutaneous leishmaniasis (chiclero's ulcer) in Mexico: sensitivity and specificity of ELISA for IgG antibodies to Leishmania mexicana mexicana.

Sera from 223 human beings were assayed by enzyme-linked immunosorbent assay for immunoglobulin G antibodies to Leishmania mexicana mexicana promastigotes. 76% of 74 sera from patients with chiclero's ulcer gave positive reactions at a titre of 1:40; the positivity rate was lower in patients with long-standing infections. False positive reactions were obtained with only 7% of 56 sera from healthy individuals with positive Montenegro tests and with 6 of 7 sera from patients with Chagas disease. It is concluded that this method would be a useful contributory diagnostic method in cases of suspected chiclero's ulcer.

Incidence of localized cutaneous leishmaniasis (chiclero's ulcer) in Mexico.

Cutaneous leishmaniasis in Mexico was first described in 1912. Since then, its existence has been repeatedly confirmed in the forest regions of the peninsula of Yucatan. In order to obtain reliable knowledge about the magnitude of this problem, we questioned and skin-tested a sample of 449 persons randomly selected from men aged 15-45 years. We found a positivity rate of 24 to 90% (mean 43%) in the seven rural health posts studied. Furthermore, 72 patients were examined between January and December 1987 by parasitological investigation (smear, isolation, culture and/or biopsy) and the Montenegro skin test; 56 had acquired the disease in 1987. Based on these data, we found an annual incidence rate of 508 per 100,000 inhabitants. Further long-term studies are indicated to determine the incidence and prevalence rates for this disease in other parts of the country.

Estudio preliminar de correlacion clinica, histopatologica e inmunologica de la leishmaniasis cutanea mexicana en el hombre. / Preliminary study of clinical, histopathological and immunological correlation of Mexican cutaneous leishmaniasis in the man

Se estudiaron un total de siete pacientes provenientes de area endemica y con cuadro clinico de leishmaniasis cutanea mexicana.Se les practicaron historia clinioepidemiologica, biopsia, evaluacion de perfil inmunologico (linfocitos T y B, determinacion de inmunoglobulinas y C3) y reaccion inmunitaria especifica (intradermorreaccion de Montenegro y ELISA). Clinicamente no se encontraron diferencias con lo informado en la literatura. El patron histopatologico es caracteristico y diferente a lo encontrado en otras leishmaniasis cutaneas. Inmunologicamente los hallazgos sobresalientes fueron hipergammaglobulinemia en 6/7 (85.71 por ciento) y ELISA positivo en 5/7 (71.42 por ciento). Se discuten las posibles correlaciones y se proponen criterios diagnosticos