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The immunopathogenesis of lupoid leishmaniasis is challenging. Although an appropriate immune response is critical for controlling these parasites, inappropriate inflammatory reactions can also promote increased pathology. The role of immune modulatory effect of the main transcription factors and cytokines of T regulatory and Th17 cells in pathogenesis of leishmaniasis chronicity was investigated in this study. The gene expression of interleukin-10 ( IL-10), transforming growth factor-β ( TGF-β 1), forkhead box P3 ( Foxp3), interleukin-17( IL-17A) and retinoic acid-related orphan receptor gamma t ( ROrC) was assessed in peripheral blood mononuclear cells of eighty blood samples from cutaneous leishmaniasis ( CL) patients with usual lesions (n = 31), lupoid lesions (n = 29) and healthy volunteers (n = 20). Quantitative relative real-time PCR ( qRT- PCR) was performed using the Taqman and Sybergreen methods for expression of target genes. Expression of Foxp3 ( P = .013), IL-10 ( P < .001) and IL-17A ( P < .001) was significantly higher in lupoid patient compare to the nonlupoid group. Expression of Foxp3 ( P < .001), IL-10 ( P < .001) and IL-17A ( P = .033) was significantly more in nonlupoid subjects than in healthy volunteers, except for RORγ t. These findings suggest that Foxp3+ cells, IL-10 and IL-17 play important roles in the immunopathogenesis of CL and that these roles differ depending on the causal leishmania species and different body compartments. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented concerning the case of a 44-year-old man with asymptomatic lesions and yellowish patches on the sides of the neck, axilla, elbow and knee flexures.