Al-Hucheimi Sundus Nsaif, Sultan Baqur A, Al-Dhalimi Muhsin A
Department of Microbiology, College of Medicine, University of Kufa, Kufa, Iraq.
Int J Dermatol. 2009 Apr;48(4):404-8. doi: 10.1111/j.1365-4632.2009.03903.x.
The diagnosis of cutaneous leishmaniasis (CL) largely depends on the clinical appearance, especially in endemic areas. A diagnostic challenge arises when the lesions appear in nonendemic areas, when the clinical picture is distorted, or when an atypical variant is seen, even in endemic regions. Aim To assess the correlation of microbiologic and histopathologic diagnosis with polymerase chain reaction (PCR) findings in clinically diagnosed cases of CL.
This was an observational and descriptive study. The patients were seen at outpatient departments of dermatology in the middle Euphrates region of Iraq. Sixty-five patients with clinically suspicious CL lesions were screened. Fifty-seven clinically diagnosed cases were then subjected to slit-skin smear and skin biopsy. PCR examination was conducted in 40 cases.
Direct slit-skin smear examination was positive in 38 patients (66.7%), and 48 specimens (84.2%) were positive by the slide-touch skin biopsy method. Histopathologic examination showed features suggestive of CL in 34 specimens (59.6%). The results of PCR examination were positive in 37 cases (92.5%).
The PCR technique is highly specific (100%) and sensitive (92.5%) for the diagnosis of CL. In addition to the confirmation of the diagnosis, it may be useful in identifying a relationship between the type of microorganism and the clinical presentation of the disease.
皮肤利什曼病（CL）的诊断很大程度上取决于临床表现，尤其是在流行地区。当病变出现在非流行地区、临床表现扭曲或出现非典型变体时，即使在流行地区，也会出现诊断挑战。目的评估临床诊断为CL的病例中微生物学和组织病理学诊断与聚合酶链反应（PCR）结果的相关性。
这是一项观察性描述性研究。在伊拉克幼发拉底河中游地区的皮肤科门诊对患者进行观察。对65例临床疑似CL病变的患者进行筛查。然后对57例临床诊断病例进行皮肤刮片涂片和皮肤活检。对40例病例进行PCR检测。
直接皮肤刮片涂片检查38例（66.7%）呈阳性，玻片触压皮肤活检法48份标本（84.2%）呈阳性。组织病理学检查显示34份标本（59.6%）有提示CL的特征。PCR检测结果37例（92.5%）呈阳性。
PCR技术对CL的诊断具有高度特异性（100%）和敏感性（92.5%）。除了确诊外，它可能有助于确定微生物类型与疾病临床表现之间的关系。
