Articles

Comparison of Leishmanin Skin Test and Direct Smear for the Diagnosis of Cutaneous Leishmaniasis

Abstract

Cutaneous leishmaniasis (CL) is an endemic disease in some parts of Iran and it has high morbidity in some areas of the country. The disease is detected by parasitological examinations including direct microscopic and culture tests. This comparative study aimed to evaluate the relationship between positivity of the leishmanin skin test (LST), microscopically examination and clinical forms of CL for the diagnosis of human cutaneous leishmaniasis. This study was performed on 66 patients suspected to cutaneous leishmaniasis. CL cases evaluated by both microscopical examination and leishmanin skin test. In this study, 1 ml of leishmanin fluid (lot no 121/1, produced in Pasteur institute of Iran) was injected intradermally in forearms of all patients and indurations were measured after 72hours. Induration of 5 mm and higher was considered as positive results. The collected data were statistically analyzed using the SPSS version 13.5. From 66 CL patients who were evaluated in this study, 30 (45.5%) of them had positive microscopically results while 28(42/4%) of them had showed positive leishmanin skin test (≥5mm diameter). From 36 (54.5%) patients who had negative microscopical examination, only 6(16/6%) of them had positive leishmanin skin test. The agreement between two tests was 87.9 % by kappa analysis (p< 0.01). In attention to the results of this study, it seems the LST would be used as an alternative diagnosis method when there is a strong clinical doubt to cutaneous leishmaniasis even there is no parasite in direct smear.

Momeni AZ, Aminjavaheri M. Clinical picture of cutaneous leishmaniasis in Isfahan, Iran. Int J Dermatol 1994;33(4):260-5.

De Luca PM, Mayrink W, Santiago MA, Nogueira R, Conceição-Silva F, Mélo G, Mendonça SC. Randomized, double-blind, placebo-controlled study on the immunogenicity of the leishmanin skin test. Trans R Soc Trop Med Hyg 2003;97(6):709-12.

The Iranian Ministry of Health, Treatment and Medical Education, Diseases Management Center. Communicable Diseases, Annual Report, 2003-2005.

Osman OF, Kager PA, Oskam L. Leishmaniasis in the Sudan: a literature review with emphasis on clinical aspects. Trop Med Int Health 2000;5(8):553-62.

Weigle KA, Valderrama L, Arias AL, Santrich C, Saravia NG. Leishmanin skin test standardization and evaluation of safety, dose, storage, longevity of reaction and sensitization. Am J Trop Med Hyg 1991;44(3):260-71.

Dowlati Y. Cutaneous leishmaniasis: clinical aspect. Clin Dermatol 1996;14(5):425-31.

De Rossell RA, Bray RS, Alexander J. The correlation between delayed hypersensitivity, lymphocyte activation and protective immunity in experimental murine leishmaniasis. Parasite Immunol 1987;9(1):105-15.

Arana BA, Roca M, Rizzo NR, Mendoza CE, Kroeger A. Evaluation of a standardized leishmanin skin test in,Guatemala. Trans R Soc Trop Med Hyg 1999;93(4):394-6.

Pampiglione S, Manson-Bahr PE, La Placa M, Borgatti MA, Micheloni F. Studies on Mediterranean leishmaniasis. IV. The leishmanin skin test in cutaneous leishmaniasis. Trans R Soc Trop Med Hyg 1976;70(1):62-5.

Faber WR, Oskam L, van Gool T, Kroon NC, Knegt-Junk KJ, Hofwegen H, van der Wal AC, Kager PA. Value of diagnostic techniques for cutaneous leishmaniasis. J Am Acad Dermatol 2003;49(1):70-4.

Sokal JE. Editorial: Measurement of delayed skin-test responses. N Engl J Med 1975;293(10):501-2.

Weigle KA, Escobar M, Arias AL, Martinez F, Rojas C. A clinical prediction rule for American cutaneous leishmaniasis in Colombia. Int J Epidemiol 1993;22(3):548-58.

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IssueVol 49, No 3 (2011) QRcode
SectionArticles
Keywords
Cutaneous leishmaniasis Leishmanin skin test Microscopical examination Human

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Hashemi SN, Mohebali M, Mansouri P, Bairami A, Hajjaran H, Akhoundi B, Charehdar S. Comparison of Leishmanin Skin Test and Direct Smear for the Diagnosis of Cutaneous Leishmaniasis. Acta Med Iran. 1;49(3):136-141.