Erysipeloid Cutaneous Leishmaniasis in the Old World: A Systematic Review
Bibliographic record
Abstract
Erysipeloid cutaneous leishmaniasis (ECL) is a rare presentation of cutaneous leishmaniasis that classically presents as erythematous, infiltrated lesions on the centrofacial region. We conducted a systematic review on the demographic characteristics, clinical presentations, laboratory findings, and treatment of ECL in the Old World. A systematic literature search was performed using the terms ("erysipeloid" OR "erysipelas") AND "leishmaniasis" across Web of Science, PubMed, Scopus, Embase, and Google Scholar. Only studies reporting cases from the Old World were included. Based on the anatomic location of lesions, we defined three clinical distributions of ECL: (1) centrofacial involvement, (2) non-centrofacial lesions involving the face and/or scalp, and (3) lesions on the neck, trunk, and extremities. Our search yielded 3290 publications, of which 24 met the inclusion criteria. In total, 103 patients with ECL, including 73 females (70.9%) and 30 males (29.1%) with a mean age ± standard deviation of 52.1 ± 12.3 years, were included. Seventy-two patients (57 females, 15 males) had centrofacial lesions. Females comprised 83.8% of this subgroup, a difference that was statistically significant (p < 0.005). ECL was more common in postmenopausal females. ECL lesions on the trunk and extremities were reported in five patients. Sixty-five patients (63.1%) were treated with pentavalent antimonials alone or in combination with other drugs. In conclusion, ECL is a rare presentation of cutaneous leishmaniasis, most often affecting elderly women and primarily localizing to the mid-face. Old age and menopause might predispose to ECL development. Clinical suspicion is necessary for the diagnosis of lesions suggestive of ECL in endemic regions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".