Demographic features and geographic localization of patients with leishmania cutis in Diyarbakir

Cutaneous Leishmaniasis is a skin infection caused by protozoan parasites of the genus Leishmania. The disease is transmitted through the bites of infected Phlebotomus flies. The disease is endemic to many parts of the World, and according to the data of the WHO, 350 million people are under risk. The disease is transmitted by the bite of infected Phlebotomus, and a papule occurs in the bite site 2-8 weeks later. This papule enlarges over time and turns into an ulcerated nodule. The lesion no treated heals generally, leaving scar within 1-2 years. In 5-10% of patients, however, the disease does not heal and becomes chronic. The risks of the disease transmission are to live in an endemic area, to travel to endemic area, lack of adequate waste management systems, as well as existence of manure piles and barns that may form an environment for favourable living conditions for Phlebotom. In addition, untreated infected individuals may also be a reservoir, leading to occurrence of new cases in that site. Therefore, for the control of the disease, it is of utmost importance to determine individuals with disease and treat them. The aim of this study is to investigate demographic and clinic features of the patients with cutaneous leishmaniasis and demonstrate their geographical distribution. The disease is endemic in Southern America, Southern Europe, Africa and Asia. Our neighbouring countries, such as Iraq, Syria and Iran are also endemic. As far as our country is concerned, while Southeastern Anatolia and Cukurova regions have been endemic since the 1950s, new cases have also been reported from the western parts of the country such as Aydın, Antalya, Hatay and Mersin. When the data of Health Ministry were investigated, no case was reported in Diyarbakır by 2002; however, 14 cases were identified in the records of Medical Faculty, Dicle University, in 2002. A total of 131 patients with cutaneous leishmaniasis, applying to the outpatient clinic of skin and veneral diseases, Medical faculty, Dicle University, between 1 January 2011 and 1 January 2013, were investigated retrospectively. The mean age of the patients was 22,4±20,4 years. Of the patients, 64,9% were between 0-19 years of age. Of them, 71 were female and 60 were male (Female/male ratio; 1.18:1). While the duration between the onset of the disease and approved to the outpatient clinic ranged from 1 to 132 months, the mean duration was 10,1±16,5 months. Of the patients, 51,1% were student, 29,9% house-wife, 2,3% worker, 5,3% farmer, 0,8% (1 patient) was lorry driver and 0,8% (1 patient) self-employed. However, 16,8% (22 patients) of the patients were unemployed. Of the patients, 81,3 (107) were in acute, 18,3% (24) were in chronic form. Of the patients in acute form, 22,4% (24) had wet type, whereas 77,5% (83) had dry type. Of the chronic form patients, 91,6% formed residive type, 8,3% chronic lupoid type. In 131 patients included into the study, 246 lesions were detected. Of the lesions, 56% (138) were located only on the face. The number of lesions in patients varied from 1 to 7. The mean number of the lesions was 1,8±1,5. The lesion diameters were between 0,5 and 9 cm. In all the patients, the diagnosis was made by seeing amastigotes through smear. While 79,4% (104) of the patients were given treatment, 20,6% (27) were not. No death case occurred due to the disease or the treatment of the disease.