CD4 and Granuloma: This leads us to believe that, different from reports of TLR9 associated with the presence of granuloma in patients with the LCL form caused by L. (V. ) braziliensis [16], TLR9 is associated with a susceptibility profile to ACL because its significant expression on the side of the spectrum associated with L. (V. ) braziliensis was only observed in the BDCL clinical form, which is also associated with a partially suppressed T-cell immune response (CD4+Th1≥Th2; DTH+/-) [3, 4, 6, 19].