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Pos Kala-azar Dermal Leishmaniasis (PKDL), una visión general global
Chaitali Ghosh1, Chaitali Karmakar1, Deblina Sarkar1
1Department of Pharmacology Institute of Postgraduate Medical Education and Research, 244B Acharya JC Bose Road, Kolkata, India.
Clinical and experimental dermatology
|January 8, 2026
Resumen
La leishmaniasis cutánea pos-kala-azar (PKDL) es una complicación cutánea persistente después del tratamiento de la leishmaniasis visceral (LV). Abordar la PKDL requiere diagnósticos integrados, inmunología y estrategias comunitarias para la eliminación del kala-azar.
Área de la Ciencia:
- Dermatología; Enfermedades Infecciosas; Inmunología
Sus antecedentes:
- La leishmaniasis cutánea pos-kala-azar (PKDL) es una secuela cutánea crónica en pacientes tratados para la leishmaniasis visceral (LV).
- La PKDL representa un desafío epidemiológico significativo en el sur de Asia, actuando como reservorio de Leishmania donovani y manteniendo la transmisión de la LV.
- Los factores de riesgo incluyen VL previa, inmunosupresión, genética del huésped, desnutrición y diagnóstico tardío debido al estigma y al comportamiento de búsqueda de atención médica deficiente.
Objetivo del estudio:
- Revisar los desafíos epidemiológicos, las dificultades diagnósticas y los obstáculos terapéuticos de la PKDL.
- Destacar los aspectos inmunológicos y el papel de las herramientas moleculares en el diagnóstico de la PKDL.
- Enfatizar la necesidad de estrategias integradas para la eliminación de la PKDL y el control sostenido de la LV.
Principales métodos:
- Revisión de la literatura y síntesis del conocimiento actual sobre la PKDL.
- Análisis de los desafíos diagnósticos, incluidas las herramientas moleculares.
- Evaluación del manejo terapéutico y sus limitaciones.
Principales resultados:
- La PKDL se presenta en formas maculares o polimorfas, con desafíos diagnósticos en etapas tempranas o maculares debido a la baja carga parasitaria.
- La enfermedad implica una respuesta inmune mixta Th1/Th2 con infiltración celular significativa.
- Los tratamientos actuales se ven obstaculizados por la duración prolongada, el riesgo de recaída, la resistencia a los medicamentos y el bajo cumplimiento.
Conclusiones:
- Los diagnósticos moleculares ofrecen una mayor sensibilidad y aplicabilidad en el campo para la detección de PKDL.
- La comprensión del perfil inmunológico es crucial para el manejo de la PKDL.
- Las estrategias integradas que combinan diagnósticos moleculares, conocimientos inmunológicos y tratamiento basado en la comunidad son esenciales para la eliminación de la PKDL y los esfuerzos generales de control del kala-azar.
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