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Table 1 A bibliographic summary of the differences between diffuse-CL and disseminated-CL cutaneous leishmaniasis in the New and Old Worlds

From: Diffuse and disseminated cutaneous leishmaniasis: clinical cases experienced in Ecuador and a brief review

Characteristics DCL DSL
Main agents   
 In the New World L. (L.) amazonensis L. (V.) braziliensis group
  L. (L.) mexicana L. (L.) mexicana group
 In the Old World L. (L.) aethiopica No specific case reports other than HIV co-infection
  L. (L.) major
No. of parasites in lesions/smears Massive/abundant in smear (uncontrolled parasite growth) Scanty/rare in smear
Leishmanin skin test Negative/poor (specifically anergic to Leishmania antigen; lack of cell-mediated immunity) Strongly positive
Reaction to TB, PPD, and other antigens Yes Yes
Antibody response Elevated, rK39+a Elevated, rK39+a
Ulceration of lesions Never (non-necrotizing) Frequent (necrotizing)
Coalescence to form plaques Frequent Rare
Type of lesions Nodules, papules, plaques, macules, erythema Papules, nodules, ulcers (mixture of small lesions)
Typical lesion Lepromatous Acneiform
Response to drug/therapy Resistant/poor, relapse frequently Good/poor
Infection/clinical course Chronic, persist 20 years or more, for a life long Not chronic
Analogous to lepromatous leprosy Yes No
Affected ages and sex All ages and sexes Young adults, maleb
No. of lesions Often innumerable, plaques on body surface 0–300b, 308c, 425d, 745e
Mucosal involvement No Frequentb
Disease entity Rare, less than 0.1 % of total CL in Venezuelaf Less than 2 % of CLb
  1. aHashiguchi et al., unpublished data
  2. bTuretz et al. [7]
  3. cLazo and Hashiguchi [15]
  4. dCouppie et al. [30]
  5. eSousa et al. [31]
  6. fConvit et al. [28]