{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:57:35Z","timestamp":1792267055143,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI099602"],"award-info":[{"award-number":["R01AI099602"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01AI136033"],"award-info":[{"award-number":["U01AI136033"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009826","name":"University of Colombo","doi-asserted-by":"publisher","award":["AP\/3\/2\/2016\/CG\/24"],"award-info":[{"award-number":["AP\/3\/2\/2016\/CG\/24"]}],"id":[{"id":"10.13039\/501100009826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment responses to cutaneous leishmaniasis (CL) observed in Sri Lanka show variability, ranging from quick healing to delayed or failed responses to routine medication. The determinants of these differences in treatment response are not well defined. This study aimed to identify predictive features of treatment response and outcome in localized CL caused by <jats:italic>Leishmania donovani<\/jats:italic>, focusing on both clinical and histopathological findings in the patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Tissue sections (<jats:italic>n<\/jats:italic>\u2009=\u2009103) derived from 3\u2009mm punch biopsies of parasitologically confirmed patients were assessed. Patients were followed up weekly until complete healing of skin lesions and were reviewed at the end of 6 months and 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Healing required 7\u201321 weekly doses of intralesional sodium stibogluconate (IL\u2010SSG) (mean\u2009=\u200912.2\u2009\u00b1\u20090.622). Twenty\u2010nine (28.1%) patients were identified as delayed responders. None had recurred at the end of 1 year. The demographic or clinical features (age, gender, lesion type, size, location, and lesion duration) did not significantly influence the treatment response. A heavy parasite load and acanthosis were significant predictors of a delayed response to treatment (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Higher parasite loads were associated with inflammation of the entire dermis (<jats:italic>P<\/jats:italic>\u2009=\u20090.008), more intense infiltration of macrophages (p\u2009=\u20090.001), and epidermal atrophy (<jats:italic>P<\/jats:italic>\u2009=\u20090.033). Well\u2010formed granulomas were inversely proportional to parasite loads.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Histology findings proved to be better prognostic markers than clinical features for delayed responders to treatment and will aid in targeted patient management when tissue biopsies are performed in the initial diagnosis of CL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.16826","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T06:48:35Z","timestamp":1695106115000},"page":"1237-1247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Histological findings associated with treatment response in cutaneous leishmaniasis: a clinicopathological correlation study"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7395-9103","authenticated-orcid":false,"given":"Hasna","family":"Riyal","sequence":"first","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine University of Colombo  Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilakshi","family":"Samaranayake","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine University of Colombo  Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyani","family":"Amarathunga","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine University of Colombo  Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepani","family":"Munidasa","sequence":"additional","affiliation":[{"name":"Teaching Hospital  Anuradhapura Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadira D.","family":"Karunaweera","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine University of Colombo  Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cimid.2004.03.004"},{"key":"e_1_2_6_3_1","unstructured":"Leishmaniasis.https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/leishmaniasis#:~:text=Anestimated50000to exposedpartsofthebody."},{"key":"e_1_2_6_4_1","first-page":"432","article-title":"Locally acquired cutaneous leishmaniasis in Sri Lanka","volume":"95","author":"Athukorale DN","year":"1992","journal-title":"J Trop Med Hyg"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(03)90061-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu102"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1179\/136485908X300779"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2008.03417.x"},{"key":"e_1_2_6_9_1","unstructured":"Guidelines for the management leishmaniasis; 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