Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina.
Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diag...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2017
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0005980 https://doaj.org/article/c9acd1b16244491190b0125cb6a3c60b |
id |
ftdoajarticles:oai:doaj.org/article:c9acd1b16244491190b0125cb6a3c60b |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:c9acd1b16244491190b0125cb6a3c60b 2023-05-15T15:15:53+02:00 Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. Alejandro Javier Krolewiecki Maria Cristina Almazan Marcelo Quipildor Marisa Juarez Jose Fernando Gil Marco Espinosa Maria Canabire Silvana Pamela Cajal 2017-10-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005980 https://doaj.org/article/c9acd1b16244491190b0125cb6a3c60b EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5645152?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005980 https://doaj.org/article/c9acd1b16244491190b0125cb6a3c60b PLoS Neglected Tropical Diseases, Vol 11, Iss 10, p e0005980 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005980 2022-12-31T12:31:34Z Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diagnosis, based on delayed type hypersensitivity responses to Leishmania antigens injected intradermally, used in endemic areas as a complement to diagnosis. A retrospective analysis of individuals evaluated for their first episode of tegumentary leishmaniasis at a reference center in Argentina during the period 2006-2015 was performed, with the goal of assessing its usefulness as a support tool in the diagnosis of leishmaniasis. Demographic, clinical and diagnostic work-up were analyzed in individuals with clinically compatible lesions, lesion`s smear and LST. A total of 733 cases that met the case definition were included in the analysis; 678 (93%) localized cutaneous cases, 50 (7%) with mucosal involvement and 5 (<1%) disseminated. Diagnostic confirmation was reached in 474 (65%) cases through positive smears from skin or mucosal lesions, with only 6 cases among this group having negative LST. Among smear negative cases, 190 were negative also by LST, but in 69 instances LST was positive. Across age groups, similar ratios of sensitivity between smear and LST were calculated. Lesions older than 21 days-old were found to correlate with positive results both for smear and LST significantly more than younger lesions. These findings support the clinical use of LST as a diagnostic complement for American Cutaneous Leishmaniasis across all age groups even in endemic areas. In this analysis, the correlation with smear was high. Standardization of this technique and further research into its most adequate preparation and utilization protocols across different sites will help in the management of suspicious clinical cases. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Argentina PLOS Neglected Tropical Diseases 11 10 e0005980 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Alejandro Javier Krolewiecki Maria Cristina Almazan Marcelo Quipildor Marisa Juarez Jose Fernando Gil Marco Espinosa Maria Canabire Silvana Pamela Cajal Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diagnosis, based on delayed type hypersensitivity responses to Leishmania antigens injected intradermally, used in endemic areas as a complement to diagnosis. A retrospective analysis of individuals evaluated for their first episode of tegumentary leishmaniasis at a reference center in Argentina during the period 2006-2015 was performed, with the goal of assessing its usefulness as a support tool in the diagnosis of leishmaniasis. Demographic, clinical and diagnostic work-up were analyzed in individuals with clinically compatible lesions, lesion`s smear and LST. A total of 733 cases that met the case definition were included in the analysis; 678 (93%) localized cutaneous cases, 50 (7%) with mucosal involvement and 5 (<1%) disseminated. Diagnostic confirmation was reached in 474 (65%) cases through positive smears from skin or mucosal lesions, with only 6 cases among this group having negative LST. Among smear negative cases, 190 were negative also by LST, but in 69 instances LST was positive. Across age groups, similar ratios of sensitivity between smear and LST were calculated. Lesions older than 21 days-old were found to correlate with positive results both for smear and LST significantly more than younger lesions. These findings support the clinical use of LST as a diagnostic complement for American Cutaneous Leishmaniasis across all age groups even in endemic areas. In this analysis, the correlation with smear was high. Standardization of this technique and further research into its most adequate preparation and utilization protocols across different sites will help in the management of suspicious clinical cases. |
format |
Article in Journal/Newspaper |
author |
Alejandro Javier Krolewiecki Maria Cristina Almazan Marcelo Quipildor Marisa Juarez Jose Fernando Gil Marco Espinosa Maria Canabire Silvana Pamela Cajal |
author_facet |
Alejandro Javier Krolewiecki Maria Cristina Almazan Marcelo Quipildor Marisa Juarez Jose Fernando Gil Marco Espinosa Maria Canabire Silvana Pamela Cajal |
author_sort |
Alejandro Javier Krolewiecki |
title |
Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. |
title_short |
Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. |
title_full |
Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. |
title_fullStr |
Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. |
title_full_unstemmed |
Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina. |
title_sort |
reappraisal of leishmanin skin test (lst) in the management of american cutaneous leishmaniasis: a retrospective analysis from a reference center in argentina. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005980 https://doaj.org/article/c9acd1b16244491190b0125cb6a3c60b |
geographic |
Arctic Argentina |
geographic_facet |
Arctic Argentina |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 10, p e0005980 (2017) |
op_relation |
http://europepmc.org/articles/PMC5645152?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005980 https://doaj.org/article/c9acd1b16244491190b0125cb6a3c60b |
op_doi |
https://doi.org/10.1371/journal.pntd.0005980 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
10 |
container_start_page |
e0005980 |
_version_ |
1766346221429981184 |