<html><head></head><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space; color: rgb(0, 0, 0); font-size: 14px; font-family: Calibri, sans-serif;"><div><div>Dear Martín</div><div><br></div><div>Thank you for this valuable information. </div><div>I believe the Koebner phenomenon may be related to the pathogenesis of the auricular lesion in my patient. </div></div><div>We detected <i>L. braziliensis</i> DNA (PCR) in sections from the primary lesion. In the next weeks we will have the PCR results in the secondary (auricular) lesion.</div><div><br></div><div>Kindest Regards</div><div>Flavio Queiroz-Telles MD, PhD</div><div>Hospital de Clinicas, Federal University of Parana</div><div>Curitiba-Brazil</div><div><br></div><div><br></div><span id="OLK_SRC_BODY_SECTION"><div style="font-family:Calibri; font-size:11pt; text-align:left; color:black; BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; PADDING-BOTTOM: 0in; PADDING-LEFT: 0in; PADDING-RIGHT: 0in; BORDER-TOP: #b5c4df 1pt solid; BORDER-RIGHT: medium none; PADDING-TOP: 3pt"><span style="font-weight:bold">From: </span> Martin Sanchez <<a href="mailto:martinsanchez1@gmail.com">martinsanchez1@gmail.com</a>><br><span style="font-weight:bold">Date: </span> Tuesday7, April, 2015 at 12:54 PM<br><span style="font-weight:bold">To: </span> Flavio Queiroz Telles <<a href="mailto:queiroz.telles@uol.com.br">queiroz.telles@uol.com.br</a>><br><span style="font-weight:bold">Cc: </span> jeffrey shaw <<a href="mailto:jayusp@hotmail.com">jayusp@hotmail.com</a>>, Leish-L <<a href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>><br><span style="font-weight:bold">Subject: </span> Re: [Leish-l] Auricular leishmaniasis<br></div><div><br></div><div dir="ltr">Dear Flavio, What you
describe is widely known as the Koebner phenomenon and ussually ocurrs long
after to certain cutaneous pathologies or lesions including CL lesions. They also tend to be
secondary lesions with no detectable parasites at least by conventional techniques
but the inflammatory process leading to the formation of the injury occurs
completely. These new lesion usually occurs after trauma (irritation burn, etc)
there are several references to this and cutaneous leishmaniasis. Also some
authors might risk to infer that this could be the phenomenon in some cases,
that originate mucosal lesions in immune suppresed patients, years after a healed skin CL lesions or the, or the appearance of a cutaneous
lesion years after having visited an endemic zone.
<p class="MsoNormal"><span lang="EN-US">Some references:</span></p><p class="MsoNormal"><span lang="EN-US">J R Army
Med Corps</span><span class=""><span lang="EN-US" style="font-size: 8pt; line-height: 115%; font-family: Arial, sans-serif;"> </span></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;font-family:Arial,sans-serif;border:1pt none windowtext;padding:0cm"><span style="outline:0px">2012<span style="outline:0px;font-style:inherit;line-height:inherit;text-align:inherit"></span></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;border:1pt none windowtext;padding:0cm">;</span></span></span></span><span class=""><b><span lang="EN-US" style="font-size:8pt;line-height:115%;font-family:Arial,sans-serif;border:1pt none windowtext;padding:0cm"><span style="outline:0px">158<span style="outline:0px;font-style:inherit;line-height:inherit;text-align:inherit"></span></span></span></b></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;border:1pt none windowtext;padding:0cm">:</span></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;font-family:Arial,sans-serif;border:1pt none windowtext;padding:0cm"><span style="outline:0px">3</span></span><span class=""><span lang="EN-US" style="font-size: 8pt; line-height: 115%; font-family: Arial, sans-serif; border: 1pt none windowtext; padding: 0cm;"> </span></span></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;border:1pt none windowtext;padding:0cm"><span style="outline:0px">225</span></span><span style="outline:0px;font-style:inherit;line-height:inherit;text-align:inherit"></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;border:1pt none windowtext;padding:0cm">-</span></span><span style="outline:0px;font-weight:inherit;font-style:inherit;line-height:inherit;text-align:inherit"></span><span class=""><span lang="EN-US" style="font-size:8pt;line-height:115%;border:1pt none windowtext;padding:0cm">228</span></span></span></p><p class="MsoNormal"><span lang="EN-US" style="font-size: 9pt; line-height: 115%; font-family: Arial, sans-serif; color: black;">M.D. Douba</span><sup><span lang="EN-US" style="font-size: 7.5pt; line-height: 115%; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;"> </span></sup><span lang="EN-US" style="font-size: 7.5pt; line-height: 115%; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;"> <sup>,</sup></span><span lang="EN-US" style="font-size: 10pt; line-height: 115%; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;">et al JEAVD
Volume 26</span>,<span lang="EN-US" style="font-size:10pt;line-height:115%;color:black"> </span><span lang="EN-US" style="font-size: 10pt; line-height: 115%; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;">Issue 10</span>,<span lang="EN-US" style="font-size:10pt;line-height:115%;color:black"> </span><span lang="EN-US" style="font-size: 10pt; line-height: 115%; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;">pages 1224–1229</span>, October
2012<span lang="EN-US" style="font-size:8pt;line-height:115%;border:1pt none windowtext;padding:0cm"></span></p><p class="MsoNormal" style="margin:0cm 3.15pt 0.0001pt 0cm;line-height:18pt;vertical-align:baseline"><span lang="EN-US" style="font-size: 10pt; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;">Mulvanery et al Journal of Cutaneous Pathology Volume 36, Issue 1, pages
53–60, January 2009</span></p><p class="MsoNormal" style="margin:0cm 3.15pt 0.0001pt 0cm;line-height:18pt;vertical-align:baseline"><span lang="EN-US" style="font-size: 10pt; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;"> Magill AJ.2005 Infect Dis Clin N Am 19 (2005) 241–266<br></span></p><p class="MsoNormal" style="margin:0cm 0cm 0.0001pt 3.15pt;line-height:18pt;vertical-align:baseline"><span lang="EN-US" style="font-size: 10pt; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;">Regards </span></p><p class="MsoNormal" style="margin:0cm 0cm 0.0001pt 3.15pt;line-height:18pt;vertical-align:baseline"><span lang="EN-US" style="font-size: 10pt; font-family: Arial, sans-serif; color: black; border: 1pt none windowtext; padding: 0cm;">Martín </span></p></div><div class="gmail_extra"><br clear="all"><div><div class="gmail_signature"><div dir="ltr">Martín A. Sánchez S. PhD<br>Laboratorio de Biología Celular<br>Instituto de Biomedicina "Dr. Jacinto Convit"<br>UCV- MSDS<br>Sàn nicolas a Providencia Apdo.4043<br>Caracas 1010A Venezuela<br>Tel: +58-212-8625326/8305323<br>Fax:+58-212-8619593/8611258</div></div></div><br><div class="gmail_quote">On Thu, Apr 2, 2015 at 7:46 PM, Flavio Queiroz Telles <span dir="ltr"><<a href="mailto:queiroz.telles@uol.com.br" target="_blank">queiroz.telles@uol.com.br</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div style="word-wrap:break-word;color:rgb(0,0,0);font-size:14px;font-family:Calibri,sans-serif"><div>Dear All</div><div>I have a patient who presented proved cutaneous leishmaniasis 3 years ago. He was successfully treated with meglumine but after 3 years he presented a secondary auricular lesion. Biopsy did not show amastigotes but histology like leishmaniasis (no parasites). Anew meglumine course was effective. Considering L. braziliensis braziliensis is the only species identified in the state of Parana, South of Brazil, is this feasible?</div><div><br></div><div>Regards</div><div><br></div><div>Flavio Queiroz telles MD, PhD</div><div>Federal University of Parana, Brazil</div><div><br></div><br><br>--<br><i> This email was sent by <a href="http://icb.usp.br" target="_blank">icb.usp.br</a> </i>
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