The relationship between severity of ulcerated lesions and immune responses in the early stage of cutaneous leishmaniasis in Ecuador.

The relationship was examined between the severity of ulcerated lesions and immune responses in 19 Ecuadorian patients in the early stages of New World cutaneous leishmaniasis. As an immunological assay, the humoral immune response was assessed by enzyme-linked immunosorbent assay (ELISA) and the cell-mediated response by delayed type skin test for leishmanial antigen (leishmanin test). There was a statistically significant correlation (r = 0.61, P less than 0.01) between the total area of ulcerated lesions and the reciprocal titre of ELISA in identical subjects. However, no significant difference was observed in the ELISA titre between patients with a single lesion and those with multiple lesions (chi 2 = 7.06, df = 5, P greater than 0.2). A correlation (r = 0.48, P less than 0.05) was observed between the area of lesions and the intensity of leishmanin test; further, the ELISA titre also correlated to the intensity of leishmanin test in the identical subjects (r = 0.71, P less than 0.01). These results suggest that the severity of ulcerated lesions relates to the activation of both the humoral and cell-mediated immune systems in the early stage of New World cutaneous leishmaniasis.