Cutaneous Leishmaniasis
Introduction
Introduction to cutaneous leishmaniasis Skin leishmaniasis, also known as skin kala-azar, is a chronic skin mucosal lesion caused by Donovan Lehman protozoa (Leishmaniadonovan). There are currently three species of Leishmania parasitic that are known to be parasitic in the human body. Donovan Leishmania is mainly parasitic to the internal organs, causing kala-azar, and also invading the skin mucosa, causing cutaneous leishmaniasis. Tropical Leishmania, which does not invade the internal organs, causes only solitary papular nodules and ulcers on the skin called oriental mites. Leishmania, a mammal, only invades the skin mucosa, called the skin mucosa leishmaniasis. Recessive cutaneous leishmaniasis is called when the protozoa are found in the skin of a cured patient and there is no visceral or skin damage in the clinic. basic knowledge The proportion of sickness: 0.002%-0.003% Susceptible people: more common in children. Mode of transmission: insect vector transmission Complications: acute lymphangitis
Cause
Cause of cutaneous leishmaniasis
Tropical Leishmania infection (95%)
The pathogen of Leishmaniasis of the skin is tropical Leishmania, and the form of the insect is not special. Cases have been found in Xinjiang, China, and the source of infection is the patient and the animal with the insect (rat).
Pathogenesis
The pathogen is tropical Leishmania, transmitted by white peony, and can also be transmitted by direct vaccination. Children are more common, and immunity is long after illness, and the incubation period ranges from several weeks to several months. When the white cockroach bites a person, a black fever patient or a diseased animal, the LD body in the blood or skin is inhaled into the white sputum stomach, and after 5 to 7 days of development and reproduction, a large number of mature flagellates are formed to be filled in the daytime. In the esophagus, throat and mouth, when the white scorpion bites humans and animals again, the flagella enters the skin or the subcutaneous tissue is infected.
Prevention
Skin leishmaniasis prevention
Thoroughly treat patients, eliminate the source of infection, eliminate the intermediate host - white peony, the infected area should eliminate the storage host - dogs, in the middle and late May of each year, with -HCH, 223, organic phosphorus, etc. Residual spraying on the walls of housing, barns and toilets.
Complication
Complications of cutaneous leishmaniasis Complications acute lymphangitis
Severe inflammation, become a wet skin ulcer, more common in the lower limbs, often accompanied by lymphangitis.
Symptom
Symptoms of cutaneous leishmaniasis common symptoms nodules inflammation
More common in male young adults, farmers are mostly, most patients have a clear history of black fever, good invasion of skin and mucous membranes, no systemic symptoms, skin lesions with erythema, plaques and nodules, can also be expressed as hypopigmentation, light spots Or ulcers, often without any self-conscious symptoms, symmetric distribution, face, part is more common, but other parts can also be involved, severe facial damage similar to the tumor-like leprosy "lion face", the course of disease is extremely slow.
Examine
Examination of cutaneous leishmaniasis
The diagnosis of this disease mainly relies on scraping the tissue from the surrounding or basal part of the ulcer lesion, or extracting the tissue fluid staining microscopic examination from the lesion nodule. The protozoa can also be diagnosed by culturing the flagellum, because there is no protozoa in the blood marrow lymph node of the disease. Does not cause anemia of leukopenia, etc., other diagnostic methods for kala-azar are not applicable to the diagnosis of this disease.
Skin lesion biopsy can be found in pathogens.
Diagnosis
Diagnosis and differentiation of cutaneous leishmaniasis
The diagnosis of this disease mainly depends on scraping the tissue from the surrounding or basal part of the ulcer lesion, or extracting the tissue fluid from the lesion nodule, staining the microscopic examination of the protozoa, and also confirming the diagnosis by checking the flagellum, due to the blood, bone marrow and lymph nodes of the disease. There is no protozoa in it, it does not cause anemia, leukopenia, etc., so other diagnostic methods for kala-azar are not suitable for the diagnosis of this disease.
The disease is sometimes difficult to diagnose, easy to miss diagnosis, clinically should be differentiated from leprosy, lupus erythematosus, rosacea, mycosis granuloma, xanthoma, skin tuberculosis, nodular syphilis, sarcoidosis.
