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2015, Volume 31, Number 2, Page(s) 126-130
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DOI: 10.5146/tjpath.2015.01300 |
Clinicopathological Evaluation of Cutaneous Leishmaniasis in the Mediterranean Region of Turkey |
Cumhur İbrahim BAŞSORGUN1, Betül ÜNAL1, Ayşe AKMAN KARAKAŞ2, Erkan ALPSOY2, Mehmet Akif ÇİFTCİOĞLU1, Soner UZUN2 |
1Department of Pathology, Akdeniz University, School of Medicine, ANTALYA, TURKEY 2Department of Dermatology, Akdeniz University, School of Medicine, ANTALYA, TURKEY |
Keywords:
Cutaneous leishmaniasis, Pathology, Granuloma |
Objective: Cutaneus leishmaniasis, a chronic self-limited disease
of the skin, is usually caused by Leishmania Tropica. It is endemic
in Southeastern Anatolia. The definitive diagnosis depends
on demonstration of the parasites by smear and culture or its
identification in tissue section. This study aimed to evaluate clinical
and histopathological skin lesions in cutaneous leishmaniasis cases in
Antalya, Turkey.
Material and Method: Our study included 28 patients diagnosed
with cutaneous leishmaniasis at the Pathology Department of
Akdeniz University Medical Faculty. Histopathological sections were
stained with Haematoxylin-Eosin, Giemsa or Leishman for visual
examination of cellular components by two dermatopathologists. The
epidermal (acanthosis, hyper-parakeratosis, atrophy, lymphocytic
exocytosis) and dermal changes that may indicate lymphohistiocytic
infiltration and granuloma formation were investigated. The parasitic
load was classified according to the modified Ridley's parasitic index.
Results: Out of 28 cases, 11 had hyperparakeratosis, 17 had
orthokeratosis, 20 had acanthosis, 4 had epidermal atrophy, and 7 had
exocytosis. Typical epithelioid cell granulomas with giant cells and
a rim of lymphocytes were present in 16 cases. Leishman-Donovan
bodies were extremely rare in typical granulomatous lesions. The
other 12 cases showed lymphohistiositic infiltration, giant cells and
prominent plasma cells. There were numerous Leishman-Donovan
bodies in these lesions.
Conclusion: We investigated the epidermal and dermal changes
that would facilitate the histopathological diagnosis of cutaneous
leishmaniasis in this study. We found that atrophy, acanthosis,
and orthokeratosis were early stage indicators, while exocytosis,
hyperparakeratosis, and atrophy were indicative of late stage disease.
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