{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T15:59:26Z","timestamp":1762271966677},"reference-count":58,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,10,9]],"date-time":"2015-10-09T00:00:00Z","timestamp":1444348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Centro Dermatol\u00f3gico Federico Lleras Acosta, E.S.E., Bogot\u00e1, Colombia"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mucocutaneous leishmaniasis is a chronic disease caused mainly by <jats:italic>Leishmania<\/jats:italic> species that belong to <jats:italic>Viannia<\/jats:italic> subgenus. It affects upper respiratory airways and may lead to deformity, dysphagia, and even death in severe cases. Diagnosis is a challenge because clinical and histopathologic changes are easily confused with other diseases, and conventional methods for parasite identification and culture have a low sensitivity. Molecular methods have been used in the last two decades. In 2007, we published a validation study using internal transcript spacers and kinetoplast <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> as molecular targets with satisfactory results. In this research, we tested <jats:italic>miniexon<\/jats:italic> gene as the target.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Mucosal tissue samples from 60 Colombian patients with clinical signs of mucocutaneous leishmaniasis were included. A composite reference standard defined 30 cases and 30 controls. Two blind observers performed patient classification and test application independently. <jats:italic>Miniexon<\/jats:italic> gene amplification generated: 226\u2013230 bp fragment for subgenus <jats:italic>Viannia<\/jats:italic>; 308 bp fragment for <jats:italic>L. amazonensis<\/jats:italic>; 340 bp fragment for <jats:italic>L. mexicana<\/jats:italic>; and 418 bp fragment for <jats:italic>L. infantum\u2010chagasi<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Polymerase chain reaction (<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>) sensitivity for fresh samples was 87.5% (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 72.2\u2013100), specificity, 95% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 83.0\u2013100), and positive likelihood ratio was 17.5 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.58\u2013118.93), similar to results obtained with paraffin\u2010embedded samples. Agreement between observers was 96% (kappa = 0.912; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.815\u20131.000) for both subgenus <jats:italic>Viannia<\/jats:italic> and <jats:italic>Leishmania<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We consider <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\u2013<jats:italic>miniexon<\/jats:italic> as a diagnostic method of first choice for mucocutaneous leishmaniasis due to its excellent diagnostic performance and its ability to discriminate between <jats:italic>Leishmania<\/jats:italic> and <jats:italic>Viannia<\/jats:italic> subgenera <jats:italic>as well as between<\/jats:italic> species belonging to <jats:italic>Leishmania<\/jats:italic> subgenus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.12910","type":"journal-article","created":{"date-parts":[[2015,10,10]],"date-time":"2015-10-10T06:39:28Z","timestamp":1444459168000},"page":"531-539","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Polymerase chain reaction\u2013<i>miniexon<\/i>: a promising diagnostic method for mucocutaneous leishmaniasis"],"prefix":"10.1111","volume":"55","author":[{"given":"Clemencia","family":"Ovalle\u2010Bracho","sequence":"first","affiliation":[{"name":"Centro Dermatol\u00f3gico Federico LLeras Acosta Bogota D.C Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yira Rosalba","family":"D\u00edaz\u2010Toro","sequence":"additional","affiliation":[{"name":"Centro Dermatol\u00f3gico Federico LLeras Acosta Bogota D.C Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Muvdi\u2010Arenas","sequence":"additional","affiliation":[{"name":"Centro Dermatol\u00f3gico Federico LLeras Acosta Bogota D.C Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,9]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"249","article-title":"Parasitologic and immunologic diagnosis of American (mucocutaneous) leishmaniasis","volume":"15","author":"Cuba Cuba CA","year":"1981","journal-title":"Bull Pan Am Health Organ"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2004.10.005"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0169-4758(85)90057-2"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2004.12.003"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1128\/JCM.37.6.1819-1823.1999","article-title":"Use of PCR in diagnosis of human American tegumentary leishmaniasis in Rio de Janeiro, Brazil","volume":"37","author":"Pirmez C","year":"1999","journal-title":"J Clin Microbiol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4269\/ajtmh.1987.36.489","article-title":"Diagnosis of cutaneous and mucocutaneous leishmaniasis in Colombia: a comparison of seven methods","volume":"36","author":"Weigle KA","year":"1987","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/515027"},{"issue":"1","key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.7705\/biomedica.v26i1.1508","article-title":"Geographic distribution of Leishmania species isolated from patients at the National Institute of Dermatology Federico Lleras Acosta E.S.E., 1995\u20132005","volume":"26","author":"Ovalle CE","year":"2006","journal-title":"Biomedica"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1808-8694(15)31181-2"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.4269\/ajtmh.2007.77.636","article-title":"Basombrio. Use of kDNA\u2010based polymerase chain reaction as a sensitive and differentially diagnostic method of American tegumentary leishmaniasis in disease\u2010endemic areas of northern Argentina","volume":"77","author":"Barrio A","year":"2007","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.7.3147-3153.2003"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(03)00040-3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2006.09.001"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-011-1463-z"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.2008.00744.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00208-13"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02762012000500014"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02762007005000061"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1413-8670(11)70176-3"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exppara.2010.06.024"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1071-5576(03)00155-2"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.109594"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1586\/eri.10.19"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2009.01272.x"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2009.03238.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2010.10-0081"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(84)90256-6"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02762001000700018"},{"key":"e_1_2_6_30_1","first-page":"7","article-title":"Utilidad diagn\u00f3stica de los m\u00e9todos laboratoriales en leishmaniasis mucosa, incluyendo la PCR","volume":"4","author":"Oddone R","year":"2004","journal-title":"Noticias T\u00e9cnicas del Laboratorio"},{"key":"e_1_2_6_31_1","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.4269\/ajtmh.1983.32.1260","article-title":"Evaluation of promastigote and amastigote antigens in the indirect fluorescent antibody test for American cutaneous leishmaniasis","volume":"32","author":"Pappas MG","year":"1983","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2009.11.004"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2012.06.010"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0026395"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000980"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02936-13"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.5.2294-2297.2004"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2006.06.009"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0031182010000089"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2009.12.002"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1991.44.536"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322008000400007"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000076009.64510.b8"},{"key":"e_1_2_6_44_1","first-page":"E281","article-title":"Localized leishmaniasis of the oral mucosa. A report of three cases","volume":"12","author":"Garcia de Marcos JA","year":"2007","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2013.07.002"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2007.12.013"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1998.tb02470.x"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2008.12.019"},{"key":"e_1_2_6_49_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4269\/ajtmh.1998.59.49","article-title":"Mucosal leishmaniasis due to Leishmania (Viannia) panamensis in Colombia: clinical characteristics","volume":"59","author":"Osorio LE","year":"1998","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2009.09-0268"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02761988000400022"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1996.54.178"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1989.41.687"},{"key":"e_1_2_6_54_1","doi-asserted-by":"crossref","first-page":"384","DOI":"10.4269\/ajtmh.2009.81.384","article-title":"The value of the otorhinolaryngologic exam in correct mucocutaneous leishmaniasis diagnosis","volume":"81","author":"Boaventura VS","year":"2009","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/165.3.528"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2001.65.456"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2008.05.007"},{"key":"e_1_2_6_58_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4269\/ajtmh.1990.42.51","article-title":"Mucosal disease caused by Leishmania braziliensis guyanensis","volume":"42","author":"Santrich C","year":"1990","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_6_59_1","doi-asserted-by":"crossref","first-page":"714","DOI":"10.4269\/ajtmh.1985.34.714","article-title":"Mucocutaneous leishmaniasis in Colombia: Leishmania braziliensis subspecies diversity","volume":"34","author":"Saravia NG","year":"1985","journal-title":"Am J Trop Med Hyg"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijd.12910","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.12910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T07:53:16Z","timestamp":1696405996000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.12910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,9]]},"references-count":58,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1111\/ijd.12910"],"URL":"https:\/\/doi.org\/10.1111\/ijd.12910","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,9]]},"assertion":[{"value":"2014-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-11-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-10-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}