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June 1978

Diagnosis and Prognosis of New World Leishmaniasis

Author Affiliations

Salvador, Brazil

Arch Dermatol. 1978;114(6):962-963. doi:10.1001/archderm.1978.01640180092029

To the Editor.—  Although we agree with Price and Silvers' statements in "New World Leishmaniasis: Serologic Aids to Diagnosis," which appeared in the October Archives (113:1415-1416, 1977), we wish to call attention to two points that were not stressed and that may be of importance to physicians in nonendemic areas who are confronted with possible cases of cutaneous leishmaniasis.Price and Silvers mention the Montenegro or intradermal test for leishmaniasis, but perhaps unduly minimize the utility of this reaction. Though antigens for the Montenegro test may not be commercially available from US manufacturers, they are available from at least one South American manufacturer (Instituto Adolfo Lutz, São Paulo, Brazil) and one European manufacturer (Burroughs Wellcome, England). The test is no more difficult to administer or interpret than a PPD reaction and gives results in 48 hours. In cutaneous leishmaniasis, as in leprosy, there is an inverse relationship between the cellular