SPONTANEOUS EVOLUTION OF CUTANEOUS LEISHM ANIASIS CAUSED BY LEISHMANIA-MAJOR IN TUNISIA

Introduction. The evolution of zoonotic cutaneous leishmaniasis (ZCL) caused by L. major, was usually described with cross-sectional studies of patients under anti-leishmanial drugs. This work aimed to describe the clinical and parasitological status by a follow-up study of patie nts with ZCL and treated with a placebo. Material and methods. In 1992 , 58 patients with unique lesion of ZCL confirmed parasitologically an d treated with vaseline twice a day or 15 days were followed in days 0 , 15, 45 and 105. During every visit we have performed a clinical desc ription of the lesion, a direct smear and a culture on NNN medium. Res ults. 81 p. 100 of the lesions were ulcerated in day 0. A rapid clinic al healing was noticed in 6.9 p. 100 of patients and the lesion remain ed active in 25.9 p. 100 of cases untill day 105. Direct smears became negative among 56.4 p. 100, 71 p. 100 and 92.3 p. 100 in days 15, 45 and 105 respectively. Discussion. The ulcer was the most frequent sign during the diagnosis. The rapid conversion of positive parasitologica l rests suggest that the diagnosis of ZCL in endemic zones should be b ased mainly on clinical criteria.