When skin and mucosae are affected the disease is known as mucocutaneous leishmaniasis. This is very rare in East Africa but frequent in South America, where it is known as "espundia". After an initial skin lesion, that slowly but spontaneously heals, chronic ulcers appear after months or years on the skin, mouth and nose, with destruction of underlying tissue (nasal cartilage, for example). Tissue destruction with disfigurement can be very severe. Parasites are usually rare in the lesions. A substantial part of the disfigurement is possibly due to immunological mechanisms. One hypothesis is a relationship between the occurrence of mucocutaneous lesions and the presence of certain alleles of polymorphic tumour necrosis factor
and
genes.
Category:
Medicine Notes
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