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Leishmaniasis A Disease With Many Names

Gianluca Nazzaro, MD1; Marco Rovaris, MD1; Stefano Veraldi, MD1
[+] Author Affiliations
1Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
JAMA Dermatol. 2014;150(11):1204. doi:10.1001/jamadermatol.2014.1015.
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Leishmaniasis is known by a myriad of popular names: Aleppo boil, Aleppo button, and Aleppo evil; Baghdad boil; Biskra button and Biskra nodule; Calcutta ulcer; chiclero ulcer; Delhi boil; Jericho button; Kandahar sore; Lahore sore; Oriental button and Oriental sore; Pian bois; Uta for cutaneous leishmania; black fever; dum-dum fever; and Kala-azar for visceral leishmania.1

Cutaneous leishmaniasis—or Oriental sore—is an ancient disease from the Old World. The first reference was found in the Ebers Papyrus (2000 bc), an Egyptian medical papyrus in which “Nile furuncle” is named. Furthermore, cutaneous leishmania may be 1 of the 12 plagues of Egypt described in the Old Testament. In the 10th century, the Persian writer Avicenna described what he called “Balkh sore” in northern Afghanistan. There is also other evidence from various places in the Middle East of an entity known as “Baghdad boil” or “Jericho button.” In India, visceral leishmaniasis was known by the term Kala-azar (“black fever” in Hindi), indicative of the terrifying effect of the disease. In 1756, Alexander Russell clinically described the cutaneous disease in a Turkish patient and called it “Aleppo boil” owing to the ugly scar that remained after its healing. In 1885, David Douglas Cunningham, a physician of the Indian Army in Calcutta, India, described what he thought to be the spores of an ulcer of “Delhi boil.” He postulated, therefore, that cutaneous leishmaniasis had a fungal etiology. In 1898, Peter Borovsky, a Russian military surgeon working in Tashkent Military Hospital (in what is now Uzbekistan), discovered the protozoan responsible for “the Oriental sore.” Three years later, William Leishman, a Scottish army doctor, identified peculiar bodies in the spleen pulp of a soldier who had died of “dum-dum fever,” and in 1903, he published his work “On the Possibility of the Occurrence of Trypanosomiasis in India” in the British Medical Journal. In the same year, Charles Donovan, professor of physiology at Madras University in India, reported similar findings and concluded that Leishman bodies were a new parasite distinct from Trypanosoma. British physician Ronald Ross sought the link between these organisms and Kala-azar and named them Leishmania donovani.

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