Clinico-histopathological analysis of cutaneous leishmaniasis

The most prevalent form of leishmaniasis is cutaneous leishmaniasis (CL), which manifests as a single ulcerative or nodular lesion that usually heals on its own. The aims of this study were to investigate the histopathologic and clinical features of CL patients.

This cross-sectional study was accomplished on 70 CL patients that referred to Razi dermatology hospital in Iran, over a five-year period from 2016 to 2020. Included patients were those who were diagnosed clinically suspected patients whom their disease was confirmed through histopathology examination.

The age of patients ranged from 2 to 76 years with a mean of 42.26 ± 20.86 years. The majority of patients were men (54.3%). The plaque form lesions were the most frequent type (64.3%). Respecting lesion site, face, and upper limbs were more frequent with the abundances of 47.1% and 34.3%, respectively. All of the patients had evidence of cellulitis on ultrasound. The most prevalent change of epidermis was hyperkeratosis (42.8%). Regarding dermal histopathologic changes, infiltration of lymphocytes (61.4%), plasma cells (58.6%), and histiocytes (48.6%), as well as granuloma formation (54.3%) and leishman body presence (54.3%) were the dominant changes. Some patients had atypical forms of CL as six of them had lupoid cutaneous leishmaniasis (LCL) and five had sporotrichoid cutaneous leishmaniasis (SCL).

In this study, men and those who were in middle age were more susceptible to be infected, so it suggests considering them particularly in the preventive programs. Moreover, histopathological findings of CL, including LCL and SCL, are presented. These findings may be beneficial for dermatologists and dermatopathologists to differentiate them from other cutaneous diseases.