The Leishmanin (Montenegro) skin test is used to assess cellular immunity in leishmaniasis. In which clinical form of the disease does this test give a NEGATIVE result despite active infection?

• A Cutaneous leishmaniasis (oriental sore)
• B Post-kala-azar dermal leishmaniasis
• C Mucocutaneous leishmaniasis
• D Diffuse cutaneous leishmaniasis ✓

Explanation

Diffuse cutaneous leishmaniasis (DCL) is characterised by a specific failure of cell-mediated immunity against Leishmania antigens, resulting in widespread non-ulcerating nodular plaques teeming with parasites. The Montenegro test is negative in DCL because of the anergic immune state. In cutaneous leishmaniasis and mucocutaneous leishmaniasis, the test is strongly positive, and in PKDL it becomes positive after cure. This immunological distinction is a key NEET PG concept.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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