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• Cutaneous leishmaniasis


  يدلجلا اينامشيللا
• Dr. Alaa Al-Gharib
• Hemoflagellates of medical importance


  • ةيبطلا ةيمهلأا تاذ تلايجلافوميهلا
• Parasitic stages (or forms)

  • Amastigote
  • Trypomastigote
  • Promastigote
  • Epimastigote
• Leishmania spp. & Trypanosoma spp. have digenetic life cycles, involving vertebrate hosts (Man & reservoir animals) and invertebrate hosts (arthropods)
• Classification of leishmaniasis


  • Cutaneous leishmaniasis
  • Mucocutaneous leishmaniasis
  • Visceral Leishmaniasis
• Old World Cutaneous leishmaniasis


  يملاعلا يدلجلا تاينامشيللا ءادميدقلا
• New World Cutaneous leishmaniasis


  يملاعلا يدلجلا تاينامشيللا ءادديدجلا
• New World Mucocutaneous leishmaniasis


  يملاعلا يطاخملا يدلجلا تاينامشيللا ءادديدجلا
• Old World Visceral leishmaniasis


  ملاعلا يف يوشحلا تاينامشيللا ءادميدقلا
• New World Visceral leishmaniasis


  يملاعلا يوشحلا تاينامشيللا ءاديدجلاد
• Infective stage


  Promastigote or Amastigote
• Transmission


  • Biological
  • Mechanical
• Bite of infected female sand flies is the biological transmission
• Direct contact and autoinfection is the mechanical transmission
• Cutaneous leishmaniasis is the most common form of leishmaniasis
• Female sand flies

  Vector (لقانلا)
• Clinically, cutaneous leishmaniasis differs according to the species of the parasite & the immunity of the patient
• Old World CL


  Caused by L. tropica complex (L. tropica, L. major & L. aethiopica)
• New World CL


  Caused by L. mexicana & L. braziliensis complexes
• Classical lesion


  1. Papule >>> Nodule

  2. Ulcerates

  3. Heals leaving a disfiguring scar
• L. tropica


  Causing chronic, dry or urban Cutaneous Leishmaniasis: Painless ulcer or Oriental sore
• L. major


  Causing acute, wet or rural Cutaneous Leishmaniasis
• L. aethiopica


  Causing diffuse (Disseminated) Cutaneous Leishmaniasis
• Diagnosis of Cutaneous leishmaniasis

  • Clinical Diagnosis
  • Laboratory Diagnosis
• Clinical Diagnosis


  • History: Residence or traveling to endemic area
  • Clinical picture
• Laboratory Diagnosis


  • Direct Methods
  • Indirect methods
• Intradermal skin test (Leishmanin or Montenegro's test)


  • Delayed hypersensitivity skin test
  • Positive test: Induration more than 5 mm at site of injection after 48 hours
  • Negative in D.C.L. (due to deficiency in cell mediated immunity)
• Aspirate or biopsy >>> PCR


  To diagnose & type the species
• Direct Laboratory Methods


  1. Aspirated tissue juice, scraping or biopsy material >>> Amastigote form

  2. Inoculation in culture [NNN medium] >>> Promastigote form

  3. Animal inoculation >> Amastigote form
• Pentostam (sodium stibogluconate) for treatment of all types of leishmaniasis