The frequency of vascular changes in the histopathology of cutaneous leishmaniasis

AUTHORS

Farhad Handjani 1 , Perika La Kumar 2 , Mandana Khosroara 3 , Maryam Sadat Sadati 4 , *

1 Molecular Dermatology Research Center & Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Dermatologist, Tehran, Iran.

4 Molecular Dermatology Research Center & Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran.

How to Cite: Handjani F , La Kumar P , Khosroara M , Sadat Sadati M . The frequency of vascular changes in the histopathology of cutaneous leishmaniasis, Hormozgan Med J. 2017 ; 21(3):e87318. doi: 10.29252/hmj.21.3.147.

ARTICLE INFORMATION

Hormozgan Medical Journal: 21 (3); e87318
Published Online: November 18, 2017
Article Type: Research Article
Received: July 14, 2017
Accepted: November 18, 2017
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Abstract

Introduction: Cutaneous leishmaniasis (CL) is a parasitic skin infection which can be
debilitating. This study was performed to determine the vascular changes in the
histopathology of CL.
Methods: Thirty-seven patients with CL were included in a prospective study. A 4 mm
punch biopsy was obtained from the border of the lesion. After histopathologic processing
and H&E staining, it was reviewed by a pathologist. In addition, 285 cases of CL, whose
biopsy files were restored at the pathology ward, during a 23 year period, were reviewed
for the assessment of vascular changes. Immunoperoxidase staining for IgG and IgA was
also performed on paraffin-embedded blocks.
Results: Out of the 37 patients with CL, 64.7% were male and 35.3% were female. In
this group, 73.5% had chronic and 26.5% had acute CL. The most common type of
lesion was an ulcerated plaque. Of the total of 322 biopsy files that were reviewed, 34
(10.5%) had vascular changes in their lesions. The vascular changes included moderate to
severe perivascular lymphocytic infiltration and severe perivascular lymphocytic
infiltration with obstruction or narrowing of vessels with or without destruction. A few
cases showed endothelial proliferation of blood vessels and one case had leukocytoclastic
vasculitis.
Conclusion: CL should be considered in the differential diagnosis of chronic cutaneous
ulcers in endemic areas, which demonstrate vascular changes or vasculitis in their
pathology. Severity of the disease may be due to the underlying intense local
inflammatory reaction, manifested as lymphocytic vasculitis.

Keywords

Cutaneous Leishmaniasis Vascular Changes Histopathology

© 2017, Hormozgan Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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