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Cutaneous leishmaniasis

Published on June 30, 2025   19 min

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Other Talks in the Series: Neglected Tropical Diseases

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My name is Michael Chance, and I would like to present a talk on cutaneous leishmaniasis prepared in collaboration with a colleague, Professor Alvaro Acosta-Serrano. The topic of visceral leishmaniasis has been the subject of another separate talk in the series.
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Descriptions of the disease we now call cutaneous leishmaniasis can be found in 19th century publications, and were usually given colloquial names with a geographical association. For example, Delhi boil, Aleppo boil, Baghdad boil and oriental sore. At the end of the century, the etiological agent of these conditions was discovered. The first slide shows the photographs of some of the investigators important in the identification of the parasite causing leishmaniasis. The first description was made by David Cunningham in 1885, who examined sections of a lesion of a patient with Delhi boil. However, he considered the parasites that he saw to be the spores produced by a fungal infection. Pyotr Borovsky, a Russian military surgeon working in Tashkent provided in 1898, the first useful description of the parasite in the samples of a Sart sore. This publication, unfortunately, remained unnoticed for decades. Our understanding of the parasite advanced in 1903 when independently, William Leishman and Charles Donovan reported parasites in samples from patients with visceral leishmaniasis. These parasites became known as Leishman-Donovan or LD bodies and were subsequently termed amastigotes. In the same year, 1903, Ronald Ross suggested the binomial name of Leishmania donovani for the parasite causing visceral leishmaniasis and thus established the term leishmaniasis for the disease caused by these parasites. In the same year, James Wright, working in Massachusetts, examining material from a cutaneous lesion from an Armenian girl gave a very detailed and accurate description of the parasites and included photomicrographs. It is interesting that most of the early investigators in these studies held posts as army medical staff. The panel on bottom left in the slide shows the appearance of amastigotes of Leishmania in stained smears. Amastigotes are small, only about 2-4 μm in diameter. Their features can be seen more clearly in the slides dealing with diagnosis. And if you're interested in the history of leishmaniasis, it is dealt with in detail in the paper by Dietmar Steverding.

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