LEISHMANIASIS— DERMAL 63 



TREATMENT. 



This is very unsatisfactory. 



Treat as for Kala-azar. 



Splenectomy is not advised as the disease is a general disorder. 



Cochran, hoAvever, claims good results from operation. 



Infected dogs should be destroyed. 



Common cleanliness will diminish the prevalence of fleas. 



Spontaneous cure does take place at times. 



Some claim good results from salvarsan. 



Antimony should be tried as for Kala-azar. 



Dermal Leishaianiasis (Oriental Sore). 



DEFINITION. 



A specific circumscribed ulceration of the skin caused by L. tropica. 



DISTRIBUTION. 



It is endemic in many tropical and sub-tropical countries. 



In the Sudan they have the non-ulcerating type. 



In South America it is known as " Forest yaws." 



It occurs in Morocco, Tunis, Tripoli, Algeria, Sahara, Egypt, 

 Congo, West, East and South Africa, Syria, Asia Minor, Mesopotamia, 

 Arabia, Persia, Caucasus, Turkestan, Valley of the Indus, N.W. 

 Provinces, Rajputana States, Crimea, Cyprus, Crete, Greece, Italy, 

 Brazil and Guiana. It is a misnomer to call the disease " Oriental 

 sore " with this distribution. 



AETIOLOGY. 



It is caused by L. tropica. 



It is conveyed by direct contact between man and man through 

 abraded surfaces or small wounds. Insects may play a part in its 

 transmission. 



There is no general infection in dogs occurring in the same parts 

 as is the case with Infantile Kala-azar, except perhaps in Persia 

 (Gachet). 



Laveran claims that house flies can carry the parasites mechanically 

 and could thus infect wounds and ulcers. 



Gachet blames the dog fly, e.g., Hippohosca canina. 



HISTOPATHOLOGY. 



There is atrophy and disappearance of the epidermis of the affected 

 parts. There is a cellular infiltration of the corium and papillae by 

 lymphoid cells, plasma cells, and large round cells. These latter, 

 which are probably proliferated endothelial cells, are packed with 

 Wright's bodies. 



