Korean J Parasitol.  2018 Jun;56(3):229-236. 10.3347/kjp.2018.56.3.229.

Diagnosis, Treatment and Clinical Features of Cutaneous Leishmaniasis in Saudi Arabia

• Hawash YA
• Ismail KA
• Abdel-Wahab MM
• Khalifa M

• KMID: 2416353
• DOI: http://doi.org/10.3347/kjp.2018.56.3.229

Abstract

Cutaneous leishmaniasis (CL) has been one of the most common parasitic diseases in Saudi Arabia. This study exhibits the clinical features, diagnosis, cytokine profile and treatment of CL patients in Al-Taif province. Ninety CL suspects at a tertiary care general hospital were enrolled in one-year study. Patients were interviewed, clinically-examined, and subjected to laboratory tests: skin scraping smear microscopy, OligoC-TesT commercial PCR (Coris BioConcept) and kinetoplast DNA (kDNA) PCR for Leishmania diagnosis. Interferon-gamma (RayBio; Human IFN-γ) and nitric oxide (NO) levels in patients' sera were evaluated before treatment with sodium stibogluconate (pentostam) with 20-day intramuscular drug regimen. Positive rates of microscopy, commercial PCR and kDNA PCR were 74.4%, 95.5% and 100%, respectively. Patients came to hospital mostly in winter (45.0%). CL was frequently exhibited in Saudi patients (78.8%), male gender (70.7%), age < 20 years (50.0%), rural-dwellers (75.5%) and patients with travel history (86.6%). Lesion was mostly single ulcer (93.3%), occurred in the face (67.7%). Upon pentostam treatment, 85.1% of ulcers showed rapid healing signs. Levels of IFN-γ and NO were significantly higher in the healing than the non-healing cases (P < 0.001). The kDNA PCR proved more sensitive than microscopy and OligoC-TesT commercial PCR. Our results open perspectives for IFN-γ use as a biomarker predicting treatment response.

Keyword

Cutaneous leishmaniasis; clinical feature; PCR diagnosis; cytokine profile

MeSH Terms

Antimony Sodium Gluconate
Diagnosis*
DNA, Kinetoplast
Hospitals, General
Humans
Interferon-gamma
Leishmania
Leishmaniasis, Cutaneous*
Male
Microscopy
Nitric Oxide
Parasitic Diseases
Polymerase Chain Reaction
Saudi Arabia*
Skin
Tertiary Healthcare
Ulcer
Antimony Sodium Gluconate
DNA, Kinetoplast
Interferon-gamma
Nitric Oxide