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Gazerani S, Huntington MK, Satvati J. Case report and literature review: Genital leishmaniasis. IDCases 2022; 29:e01596. [PMID: 36051985 PMCID: PMC9424603 DOI: 10.1016/j.idcr.2022.e01596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
The majority of genital ulcers are caused by sexually transmitted infections, though there are also other infectious and noninfectious etiologies. We present here an unusual cause of a penile ulcer due to cutaneous leishmaniasis, along with a review of the literature regarding such cases. The patient recovered following timely initiation of treatment. Rapid diagnosis of this case was aided by occurring in the context of a concurrent outbreak of cutaneous leishmaniasis in the region in which the patient resided
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Affiliation(s)
- Sasan Gazerani
- Department of Physiology, Saveh University of Medical Sciences, Saveh, Islamic Republic of Iran
- Corresponding author.
| | - Mark K. Huntington
- The Center for Family Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA
| | - Javad Satvati
- Noor Medical Laboratory, Saveh, Islamic Republic of Iran
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Lopes JV, Michalsky ÉM, Pereira NCL, Paula AJVD, Souza AGM, Pinheiro LC, Lima ACVMDR, Avelar DMD, França-Silva JC, Lanzetta VAS, Melo JD, Fortes-Dias CL, Dias ES. Canine visceral leishmaniasis in area with recent Leishmania transmission: prevalence, diagnosis, and molecular identification of the infecting species. Rev Soc Bras Med Trop 2020; 53:e20200141. [PMID: 32935783 PMCID: PMC7491567 DOI: 10.1590/0037-8682-0141-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/15/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Canine visceral leishmaniasis (CVL) is an endemic disease in Brazil, and
integrated control actions have been adopted by the Brazilian Ministry of
Health to control its spread. However, the transmission profile is unknown
in areas with recent CVL cases, including Itaúna, located in the Brazilian
state of Minas Gerais, where the present study was carried out. METHODS: A total of 2,302 dogs from 12 neighborhoods were serologically tested for
canine VL using the current diagnostic protocol adopted by the Brazilian
Ministry of Health. Test positivity rate (TPR) and CVL prevalence were
determined for each neighborhood. The presence of
Leishmania was assessed in 60 seropositive dogs which
had been recommended for euthanasia. Twenty-two of them (37%) were
asymptomatic, and 38 (63%) were symptomatic for CVL. Parasitological
(myeloculture and smear/imprint) and molecular (PCR) methods were employed
for Leishmania detection in bone marrow, spleen, mesenteric
lymph nodes, and ear skin. The infecting Leishmania species
was identified by DNA sequencing. RESULTS: CVL prevalence (per 1,000 dogs) varied from 0.0-166.67, depending on the
neighborhood, with a mean of 68.96 (SD 51.38). Leishmania
DNA was detected in at least one tissue from all seropositive dogs, with
comparable TPR among tissues. Leishmania parasites were
identified in most (54/60) seropositive dogs, and the infecting parasite was
identified as Leishmania infantum in all of these. CONCLUSIONS: Prevalence of CVL is a contributor to the spread of visceral leishmaniasis
in Itaúna.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jarbas de Melo
- Prefeitura Municipal de Itaúna, Centro de Controle de Zoonoses, Itaúna, MG, Brasil
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Boechat VC, Pereira SA, Júnior AAVM, dos Santos SA, Miranda LDFC, Figueiredo FB, Ferreira LC, de Carvalho Rodrigues FDC, de Oliveira RDVC, -de-Freitas RT, Bruno RV, Morgado FN, Menezes RC. Frequency, active infection and load of Leishmania infantum and associated histological alterations in the genital tract of male and female dogs. PLoS One 2020; 15:e0238188. [PMID: 32870947 PMCID: PMC7462300 DOI: 10.1371/journal.pone.0238188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/11/2020] [Indexed: 11/25/2022] Open
Abstract
Visceral leishmaniasis caused by the protozoan Leishmania infantum is a zoonosis. The domestic dog is the primary reservoir in urban areas. This study aimed to evaluate the frequency, active infection and load of L. infantum in the genital tract of male and female dogs seropositive for this parasite, as well as to identify histological genital alterations associated with this protozoan. We studied 45 male and 25 female L. infantum-seropositive noncastrated dogs from the same endemic area in Brazil. Tissue samples from the testis, epididymis, prostate, vulva, vagina, and uterus were examined by singleplex qPCR and parasitological tests (histopathology, immunohistochemistry, and parasitological culture). The latter were performed for the detection of active infection (parasites able to multiply and to induce lesions). Forty-four (98%) males and 25 (100%) females were positive for L. infantum in the genital tract (epididymis: 98%; vulva: 92%; vagina: 92%; testis: 91%; uterus: 84%; prostate: 66%). Active infection in the genital tract was confirmed in 69% of males and 64% of females (32% in the uterus). Parasite loads were similar in the testis, vulva, epididymis and vagina and lower in the prostate. Only the parasite load in the vagina was significantly associated with the number of clinical signs. Granulomatous inflammation predominated in all organs, except for the prostate. Only in the testis and epididymis was the inflammatory infiltrate significantly more intense among dogs with a higher parasite load in these organs. The high frequency, detection of active infection and similarity of L. infantum loads in the genital tract of infected males and females suggest the potential of venereal transmission of this parasite by both sexes and of vertical transmission by females in the area studied. Additionally, vertical transmission may be frequent since active L. infantum infection was a common observation in the uterus.
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Affiliation(s)
- Viviane Cardoso Boechat
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandro Antonio Pereira
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Artur Augusto Velho Mendes Júnior
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Shanna Araujo dos Santos
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luciana de Freitas Campos Miranda
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Luiz Claudio Ferreira
- Serviço de Anatomia Patológica, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Rayane Teles -de-Freitas
- Laboratório de Biologia Molecular de Insetos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rafaela Vieira Bruno
- Laboratório de Biologia Molecular de Insetos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular (INCT-EM)/CNPq, Rio de Janeiro, Brazil
| | - Fernanda Nazaré Morgado
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Rodrigo Caldas Menezes
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- * E-mail:
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Giunchetti RC, Silveira P, Resende LA, Leite JC, Melo-Júnior OADO, Rodrigues-Alves ML, Costa LM, Lair DF, Chaves VR, Soares IDS, de Mendonça LZ, Lanna MF, Ribeiro HS, Maia-Gonçalves AA, Santos TAP, Roatt BM, Aguiar-Soares RDO, Vitoriano-Souza J, das Dores Moreira N, Mathias FAS, Cardoso JMDO, Coura-Vital W, Galdino AS, Viana KF, Martins-Filho OA, Silveira-Lemos DD, Dutra WO, Reis AB. Canine visceral leishmaniasis biomarkers and their employment in vaccines. Vet Parasitol 2019; 271:87-97. [PMID: 31303211 DOI: 10.1016/j.vetpar.2019.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/20/2019] [Accepted: 05/17/2019] [Indexed: 12/27/2022]
Abstract
The natural history of canine visceral leishmaniasis (CVL) has been well described, particularly with respect to the parasite load in different tissues and immunopathological changes according to the progression of clinical forms. The biomarkers evaluated in these studies provide support for the improvement of the tools used in developing vaccines against CVL. Thus, we describe the major studies using the dog model that supplies the rationale for including different biomarkers (tissue parasitism, histopathology, hematological changes, leucocytes immunophenotyping, cytokines patterns, and in vitroco-culture systems using purified T-cells subsets and macrophages infected with L. infantum) for immunogenicity and protection evaluations in phases I and II applied to pre-clinical and clinical vaccine trials against CVL. The search for biomarkers related to resistance or susceptibility has revealed a mixed cytokine profile with a prominent proinflammatory immune response as relevant for Leishmania replication at low levels as observed in asymptomatic dogs (highlighted by high levels of IFN-γ and TNF-α and decreased levels in IL-4, TGF-β and IL-10). Furthermore, increased levels in CD4+ and CD8+ T-cell subsets, presenting intracytoplasmic proinflammatory cytokine balance, have been associated with a resistance profile against CVL. In contrast, a polyclonal B-cell expansion towards plasma cell differentiation contributes to high antibody production, which is the hallmark of symptomatic dogs associated with high susceptibility in CVL. Finally, the different studies used to analyze biomarkers have been incorporated into vaccine immunogenicity and protection evaluations. Those biomarkers identified as resistance or susceptibility markers in CVL have been used to evaluate the vaccine performance against L. infantum in a kennel trial conducted before the field trial in an area known to be endemic for visceral leishmaniasis. This rationale has been a guiding force in the testing and selection of the best vaccine candidates against CVL and provides a way for the veterinary industry to register commercial immunobiological products.
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Affiliation(s)
- Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil.
| | - Patricia Silveira
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Lucilene Aparecida Resende
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Jaqueline Costa Leite
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Otoni Alves de Oliveira Melo-Júnior
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Marina Luiza Rodrigues-Alves
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Laís Moreira Costa
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Daniel Ferreira Lair
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Vinícius Rossi Chaves
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Ingrid Dos Santos Soares
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Ludmila Zanandreis de Mendonça
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Mariana Ferreira Lanna
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Helen Silva Ribeiro
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Ana Alice Maia-Gonçalves
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Thaiza Aline Pereira Santos
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Bruno Mendes Roatt
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Rodrigo Dian Oliveira Aguiar-Soares
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Juliana Vitoriano-Souza
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Nádia das Dores Moreira
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Fernando Augusto Siqueira Mathias
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Jamille Mirelle de Oliveira Cardoso
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Wendel Coura-Vital
- Department of Clinical Analysis, School of Pharmacy, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
| | - Alexsandro Sobreira Galdino
- Microbial Biotechnology Laboratory, Federal University of São João Del-Rei, CEP 35501-296, Divinópolis, MG, Brazil
| | - Kelvinson Fernandes Viana
- Laboratory of Biochemistry and Molecular Biology, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, CEP 85870-901, Foz do Iguaçu, PR, Brazil
| | - Olindo Assis Martins-Filho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Institute, FIOCRUZ-Minas, CEP 30190-002, Belo Horizonte, MG, Brazil
| | - Denise da Silveira-Lemos
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Institute, FIOCRUZ-Minas, CEP 30190-002, Belo Horizonte, MG, Brazil
| | - Walderez Ornelaz Dutra
- Laboratory of Biology of Cell Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, CEP 31270-901, Belo Horizonte, MG, Brazil
| | - Alexandre Barbosa Reis
- Laboratory of immunopathology, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil; Department of Clinical Analysis, School of Pharmacy, Federal University of Ouro Preto, CEP 35400-000, Ouro Preto, MG, Brazil
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Lopes VV, Belo VS, Pereira DA, Coelho MB, Pena HP, Alves NR, de Carvalho Júnior CG, Werneck GL, Paz GF, de Azambuja Ribeiro RIM, da Silva ES, Teixeira-Neto RG. IgG avidity index and complete blood count as biomarkers of clinical disease in naturally infected dogs with Leishmania infantum. Vet Parasitol 2018; 261:96-103. [PMID: 30253858 DOI: 10.1016/j.vetpar.2018.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/25/2018] [Accepted: 08/30/2018] [Indexed: 02/07/2023]
Abstract
Canine visceral leishmaniosis (CVL), a parasitic disease caused by Leishmania infantum, may evolve to a chronic condition and lead to death. Evaluation of infected dogs is important to establish the clinical and laboratory parameters involved in the evolution of the disease. The objectives of the present study were to discriminate a canine population (n = 52) into sub-clinical and clinically affected dogs based on signs and scores, to evaluate the hematological, biochemical, histopathological and parasitological parameters of the two dog groups, and to analyze the results by multivariate regression analysis with the aim of establishing biomarkers of CVL clinical disease. The most common signs observed in the clinically affected dogs (n = 29) were hyperkeratosis, weight loss, onychogryphosis, pale mucosa and lymphadenomegaly. In the multivariate analysis, animals presenting high IgG avidity index and low red blood, lymphocyte and eosinophil counts, and low serum urea concentration had an increased probability of being classified as clinically affected (p < 0.05). All five parameters were considered to be strong biomarkers for monitoring the clinical disease, while IgG avidity percentage was strongly correlated with the number of clinical signs and could function as an indicator of the duration of infection. This is the first report on the application of IgG avidity and of multivariate regression analysis in establishing associations between the clinical signs of CVL and host biomarkers. Since avidity index (AI) percentages were strongly correlated with the number of clinical signs, it could be useful in clinical practice for auxiliary diagnosis of CVL and monitoring disease progression. A limitation of this study is the lack of information on co-infections by Anaplasma platys, Babesia canis vogeli, Ehrlichia canis and Hepatozoon canis. Therefore future studies should evaluate the influence of such co-infections on the associations studied using multivariate methods with larger samples.
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Affiliation(s)
- Valeriana Valadares Lopes
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil.
| | - Vinícius Silva Belo
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil.
| | - Diego Andrade Pereira
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
| | - Marina Bellico Coelho
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
| | - Heber Paulino Pena
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
| | - Natália Ribeiro Alves
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil
| | | | | | - Gustavo Fontes Paz
- Instituto de Pesquisas René Rachou - Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil
| | | | - Eduardo Sergio da Silva
- Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, MG, Brazil.
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Canine Leishmaniasis: An Overview of the Current Status and Strategies for Control. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3296893. [PMID: 29789784 PMCID: PMC5896350 DOI: 10.1155/2018/3296893] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 02/18/2018] [Indexed: 02/02/2023]
Abstract
Canine leishmaniasis (CanL) is a vector-borne disease caused by Leishmania infantum and is transmitted by female phlebotomine sand flies primarily between animals and secondarily to humans. The course of infection may be different from one individual dog to another, ranging from spontaneous cure to acute evolution that leads to death, if proper management and therapy are not adopted. A parasitological cure is rarely achieved and clinical recurrences in CanL are frequent. Vaccination associated with the use of topical insecticides is undoubtedly the most effective form of prevention and control of the disease. In order to integrate the most important scientific knowledge of the literature in one objective publication, this review proposes a short overview of the main points of CanL.
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Association between mast cells, tissue remodelation and parasite burden in the skin of dogs with visceral leishmaniasis. Vet Parasitol 2017; 243:260-266. [PMID: 28807304 DOI: 10.1016/j.vetpar.2017.05.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 11/21/2022]
Abstract
Canine visceral leishmaniosis (CVL) is a zoonosis of major public health impact caused by organisms of the genus Leishmania which is transmitted to human and animals by phlebotomine sand flies. The skin is the first point of contact with Leishmania parasites for sandy fly vectors and it is considered an important reservoir compartment in infected dogs. The aim of this study was to determine the main histophatologic alterations in ear skin of dogs naturally infected by Leishmania infantum with different clinical status and different degrees of parasitism. Therefore, thirty-four dogs naturally infected with L. infantum were grouped according to their clinical status in asymptomatic (AD, n=11), oligosymptomatic (OD, n=11) and symptomatic dogs (SD, n=12) as well as their degrees of parasite load in the skin as low (LP, n=11), median (MP, n=11) and high (HP, n=12) parasitism. Additionally, ten dogs were used as control (CD, n=10). At necropsy, skin samples were collected for further histological and parasitological analysis. The OD and SD groups presented higher parasite burden than AD group. The inflammation was higher in SD group when compared to OD and AD. The LP, MP and HP groups showed an increasing inflammatory process, indicating that a great parasite load is accompanied by a major inflammatory process in the skin. The number of mast cells was higher in the OD and LP groups than CD group, suggesting that these cells may be involved in tissue remodeling, since that an increase of type III collagen fibers and decrease type I collagen fibers were observed in these groups. Taken together, our results enable a better understanding of the alterations in skin of CVL dogs and consequently new insights about the pathogenesis of CVL.
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