BACKGROUNDAmerican tegumentary leishmaniasis has an annual incidence of 1 to 1.5 million
cases. In some cases, the patient's immune response can eliminate the parasite,
and the lesion spontaneously resolves. However, when this does not occur, patients
develop the disseminated form of the disease. OBJECTIVETo investigate the association between clinical, laboratory and pathological
findings in cases of American tegumentary leishmaniasis. METHODSA retrospective study of the medical records of 47 patients with American
cutaneous leishmaniasis. Clinical, laboratory and epidemiological data were
collected, and semi-quantitative histopathological analyses were performed using
the Spearman correlation coefficient (p <0.05). RESULTSMean patient age was 40.5 years. A total of 29.7% individuals were female and
70.2% were male, and 40.4% of the patients were farmers. The ulcerative form was
found in 53.2% of patients, of whom 59.6% had lesions in the limbs. The average
time to diagnosis was 22.3 months. The following positive correlations were
significant: age and duration of the disease, Montenegro reaction, degree of
granulomatous transformation and epithelioid cell count; duration of disease,
Montenegro reaction and number of lymphocytes; epithelial hyperplasia and edema,
hemorrhaging, and epithelial aggression; number of plasmocytes and number of
parasites. The main negative correlations found were as follows: age and serology;
time and parasite load; epithelial hyperplasia and degree of granulomatous
transformation. CONCLUSIONThe long duration of the disease could be explained by the fact that lesions were
relatively asymptomatic, and therefore ignored by patients with low literacy
levels. Individuals may have simply waited for spontaneous healing, which proved
to be dependent on the activation of hypersensitivity mechanisms.