Diagnostic Microscopic Features of Cutaneous Leishmaniasis other than Leishmania Tropica Bodies

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Diagnostic Microscopic Features of Cutaneous Leishmaniasis other than Leishmania Tropica Bodies

Asma Khalid *, Syed Afaq Ahmed **, Anwar Ul Haque ***, Rushqia Mukhtar ****
* Department of Dermatology Islamic International medical College Rawalpindi Pakistan ** Department of
Dermatology, Pakistan Institute of Medical Sciences (PIMS) Islamabad.
***Department of Pathology Azad Jammu and Kashmir medical College Muzaffarabad Pakistan.
****Consultant Dermatologist PAEC Islamabad

Objective: Delineate the histological features which can help in diagnosis of cutaneous leishmaniasis other than
the presence of Leishmania Tropica Bodies
Study Design: Prospective descriptive study.
Place and Duration of Study: Departments of Dermatology and Pathology, Pakistan Institute of Medical Sciences, Islamabad from January 2008 to July 2008.
Material and Methods: 35 patients presenting to Dermatology OPD with initial clinical diagnosis of CL were
included in this study. Patients with all ages and both sexes were included. Patients already on treatment were
excluded. Skin biopsies were taken, stained with hematoxyline & eosin stain (H & E stain) and studied in
collaboration with dermatopathologist. Different histopathological findings were recorded and results analyzed.
Results: Leishmania Tropica Bodies were found in (43 %) of patients. Other histological features helping in
diagnosis of CL even in the absence of LT bodies were Plasma cell infiltrate (77 %), Giant cells (34 %), Granuloma
(34 %), Lymphocytic infiltrate (28.5 %), Ulcer/scab (17 %), Epithelioid cells (14 %). Most common epidermal
features were hyperkeratosis (77%), acanthosis (44%), ulcer/scab (17%), atrophy (8.5%). pseudocarcinomatous
hyperplasia and mixed patterns were also seen.
Conclusion: LT bodies considered to be diagnostic for CL are found in 43 % of patients other than history and
clinical examination; histological features which can add to the diagnosis include plasma cells infiltrates, giant cells, epithelioid cells, granuloma formation, ulcer/scab and mixed dermal infiltrate.
Key words: Cutaneous Leishmaniasis, Leishmania, Skin biopsy.

         

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