Moravvej Hamideh, Vesal Parvaneh, Abolhasani Ehsan, Nahidi Shizar, Mahboudi Fereidoun
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Biotechnology Research Center, Pasteur Institute, Pasteur Square, South Karegar Blvd., Tehran, Iran.
Indian J Dermatol. 2014 May;59(3):316. doi: 10.4103/0019-5154.131453.
leishmaniasis infection might manifest as sarcoidosis; on the other hand, some evidences propose an association between sarcoidosis and leishmaniasis. Most of the times, it is impossible to discriminate idiopathic sarcoidosis from leishmaniasis by conventional histopathologic exam.
We performed a cross-sectional study to examine the association of sarcoidosis with leishmaniasis in histopathologically diagnosed sarcoidal granuloma biopsy samples by polymerase chain reaction (PCR).
We examined paraffin-embedded skin biopsy samples obtained from patients with clinical and histopathological diagnosis as naked sarcoidal granuloma, referred to Skin Research Center of Shaheed Beheshti Medical University from January 2001 to March 2010, in order to isolate Leishmania parasite. The samples were reassessed by an independent dermatopathologist. DNA extracted from all specimens was analyzed by the commercially available PCR kits (DNPTM Kit, CinnaGen, Tehran, Iran) to detect endemic Leishmania species, namely leishmania major (L. major).
L. major was positive in PCR of Eight out of twenty-five examined samples.
Cutaneous leishmaniasis may be misinterpreted as sarcoidosis; in endemic areas, when conventional methods fail to detect Leishmania parasite, PCR should be utilized in any granulomatous skin disease compatible with sarcoidosis, regardless of the clinical presentation or histopathological interpretation.
利什曼病感染可能表现为结节病;另一方面,一些证据表明结节病与利什曼病之间存在关联。大多数情况下,通过传统组织病理学检查无法区分特发性结节病和利什曼病。
我们进行了一项横断面研究,通过聚合酶链反应(PCR)检测组织病理学诊断为结节状肉芽肿的活检样本中结节病与利什曼病的关联。
我们检查了2001年1月至2010年3月期间转诊至谢赫·贝赫什提医科大学皮肤研究中心、临床和组织病理学诊断为裸结节状肉芽肿的患者的石蜡包埋皮肤活检样本,以分离利什曼原虫。样本由一名独立的皮肤病理学家重新评估。使用市售的PCR试剂盒(DNP™试剂盒,CinnaGen,伊朗德黑兰)对所有标本提取的DNA进行分析,以检测地方性利什曼原虫物种,即硕大利什曼原虫(L. major)。
在25份检测样本中,有8份样本的PCR检测显示硕大利什曼原虫呈阳性。
皮肤利什曼病可能被误诊为结节病;在流行地区,当传统方法无法检测到利什曼原虫时,对于任何与结节病相符的肉芽肿性皮肤病,无论临床表现或组织病理学解释如何,都应使用PCR进行检测。