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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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