<div dir="ltr">I am in agreement with Dr. Bastien for the parasite sequencing approach to differentiate r<span style="color:rgb(106,106,106);line-height:18.2000007629395px">ecrudescence from new infection. Sequence identity however may be inconclusive, since it may not exclude re-infection by the same genotype in the same endemic site. It is the best, if at all possible, to sequence DNA PCR-amplified directly from lesion parasites. Cultivation of parasites from the lesion samples may be difficult for L brasiliensis. It may further select for cultivable subtypes among the hetergenous populations in the lesion.</span><div><span style="color:rgb(106,106,106);line-height:18.2000007629395px"><br></span></div><div><span style="color:rgb(106,106,106);line-height:18.2000007629395px">KP</span></div></div><div class="gmail_extra"><br><div class="gmail_quote">On Wed, Apr 22, 2015 at 8:33 AM, Patrick Bastien <span dir="ltr"><<a href="mailto:patrick.bastien@univ-montp1.fr" target="_blank">patrick.bastien@univ-montp1.fr</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">My question is : haw can you affirm that this is a secondary lesion? (instead of a new infection). There is the same problem with relapses of L. infantum VL. In my opinion, the only way to know that is to isolate the parasite in both lesions and to type it in the most detailed way (extensive DNA sequencing?). We have also achieved this with molecular karyotypes (PFGE)(see Fig. 1 in pdf attached).<br>
Best regards<br>
<br>
Pr Patrick Bastien<br>
Director, Departement de Parasitologie-Mycologie<br>
Centre National de Reference des Leishmanioses<br>
Vice-Director, "MiVEGEC" unit research UMR5290 CNRS/224 IRD/UM1/UM2<br>
Faculte de Medecine, Université Montpellier 1<br>
39 Av. Charles Flahault<br>
34295 Montpellier cedex 5<br>
<br>
<br>
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Date : Tue, 07 Apr 2015 21:58:01 -0300<br>
De : Flavio Queiroz Telles <<a href="mailto:queiroz.telles@uol.com.br" target="_blank">queiroz.telles@uol.com.br</a>><br>
Répondre à : Flavio Queiroz Telles <<a href="mailto:queiroz.telles@uol.com.br" target="_blank">queiroz.telles@uol.com.br</a>><br>
Objet : [Leish-l] [Possivel Spam] Re: Auricular leishmaniasis<br>
À : Martin Sanchez <<a href="mailto:martinsanchez1@gmail.com" target="_blank">martinsanchez1@gmail.com</a>><br>
Cc : Leish-L <<a href="mailto:leish-l@lineu.icb.usp.br" target="_blank">leish-l@lineu.icb.usp.br</a>>, jeffrey shaw <<a href="mailto:jayusp@hotmail.com" target="_blank">jayusp@hotmail.com</a>><br>
<br>
<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
Dear Martín<br>
<br>
Thank you for this valuable information.<br>
I believe the Koebner phenomenon may be related to the pathogenesis of the<br>
auricular lesion in my patient.<br>
We detected L. braziliensis DNA (PCR) in sections from the primary lesion.<br>
In the next weeks we will have the PCR results in the secondary (auricular)<br>
lesion.<br>
<br>
Kindest Regards<br>
Flavio Queiroz-Telles MD, PhD<br>
Hospital de Clinicas, Federal University of Parana<br>
Curitiba-Brazil<br>
<br>
<br>
From: Martin Sanchez <<a href="mailto:martinsanchez1@gmail.com" target="_blank">martinsanchez1@gmail.com</a>><br>
Date: Tuesday7, April, 2015 at 12:54 PM<br>
To: Flavio Queiroz Telles <<a href="mailto:queiroz.telles@uol.com.br" target="_blank">queiroz.telles@uol.com.br</a>><br>
Cc: jeffrey shaw <<a href="mailto:jayusp@hotmail.com" target="_blank">jayusp@hotmail.com</a>>, Leish-L <<a href="mailto:leish-l@lineu.icb.usp.br" target="_blank">leish-l@lineu.icb.usp.br</a>><br>
Subject: Re: [Leish-l] Auricular leishmaniasis<br>
<br>
Dear Flavio, What you describe is widely known as the Koebner phenomenon and<br>
ussually ocurrs long after to certain cutaneous pathologies or lesions<br>
including CL lesions. They also tend to be secondary lesions with no<br>
detectable parasites at least by conventional techniques but the<br>
inflammatory process leading to the formation of the injury occurs<br>
completely. These new lesion usually occurs after trauma (irritation burn,<br>
etc) there are several references to this and cutaneous leishmaniasis. Also<br>
some authors might risk to infer that this could be the phenomenon in some<br>
cases, that originate mucosal lesions in immune suppresed patients, years<br>
after a healed skin CL lesions or the, or the appearance of a cutaneous<br>
lesion years after having visited an endemic zone.<br>
<br>
Some references:<br>
J R Army Med Corps 2012;158:3 225-228<br>
M.D. Douba ,et al JEAVD Volume 26, Issue 10, pages 1224?1229, October 2012<br>
Mulvanery et al Journal of Cutaneous Pathology Volume 36, Issue 1, pages<br>
53?60, January 2009<br>
Magill AJ.2005 Infect Dis Clin N Am 19 (2005) 241?266<br>
<br>
Regards<br>
Martín<br>
<br>
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: <a href="tel:%2B58-212-8625326" value="+582128625326" target="_blank">+58-212-8625326</a>/8305323<br>
Fax:<a href="tel:%2B58-212-8619593" value="+582128619593" target="_blank">+58-212-8619593</a>/8611258<br>
<br>
On Thu, Apr 2, 2015 at 7:46 PM, Flavio Queiroz Telles<br>
<<a href="mailto:queiroz.telles@uol.com.br" target="_blank">queiroz.telles@uol.com.br</a>> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
Dear All<br>
I have a patient who presented proved cutaneous leishmaniasis 3 years ago. He<br>
was successfully treated with meglumine but after 3 years he presented a<br>
secondary auricular lesion. Biopsy did not show amastigotes but histology like<br>
leishmaniasis (no parasites). Anew meglumine course was effective. Considering<br>
L. braziliensis braziliensis is the only species identified in the state of<br>
Parana, South of Brazil, is this feasible?<br>
<br>
Regards<br>
<br>
Flavio Queiroz telles MD, PhD<br>
Federal University of Parana, Brazil<br>
<br>
<br>
<br>
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