Leishmanin skin testing in the diagnosis of American cutaneous leishmaniasis

Two hundred thirty-three British troops were tested before and 2 months after a 6-month period in Belize. No erythematous indurated reactions developed on the initial tests; four subjects developed such reactions on the second test. Three of these subjects had skin ulcers at the time of the second test; the fourth developed an ulcer 2 weeks later. Leishmania braziliensis sp were isolated from all of these ulcers. Two subjects who showed no reaction on either of their tests developed skin ulcers within 1 month of the second test. Leishmania braziliensis sp were isolated from these ulcers. The leishmanin test performed 2 months after return from an endemic area does not provide a satisfactory screening test for leishmaniasis. An indurated reaction correlates well with the presence of disease, but a negative reaction does not exclude this developing later.