Sharquie Khalifa E, Hameed Ammar F, Noaimi Adil A
Scientific Council of Dermatology and Venereology Iraqi Board for Medical Specializations, Baghdad, Iraq.
Indian J Pathol Microbiol. 2016 Jan-Mar;59(1):16-9. doi: 10.4103/0377-4929.178216.
Cutaneous leishmaniasis (CL) is a parasitic cutaneous infection caused by Leishmania parasite. The histopathology is usually granulomatous in nature.
The aim of the present study is to elucidate the histology of CL and evaluate the presence and the frequency of panniculitis among the affected patients.
Case series interventional study.
Thirty-five patients with CL were diagnosed clinically between December-2012 and May-2013. Diagnostic confirmation established by smears, culture, and polymerase chain reaction (PCR). The histopathological assessment was carried out to study the general pathology and to look for the presence of panniculitis.
Simple statistics utilized via SPSS version 16.0 (SPSS, Inc., Chicago, USA).
Eighteen women and 17 men with CL were enrolled in the present work with a mean duration of their disease was 3 months. The results of the diagnostic tests were as follow: The smear was positive in 21 (60%) of cases, Leishman-Donovan (LD) bodies were seen in 7 (20%) patients, culture was positive in 24 (68%), and PCR was positive in 32 (91.4%) patients. The epidermal changes included acanthosis, pseudoepitheliomatous hyperplasia, ulceration, focal spongiosis, and interface dermatitis while the dermal changes were dependent on the spectrum of the disease, so in the ulcerative lesions there was lymphohistiocytic infiltration with foci of plasma cells and sometimes aggregate of LD bodies, whereas in the dry lesions the pathology is mainly of epithelioid granuloma. Panniculitis was seen in 16 (46%) cases as a diffuse lymphohistiocytic infiltration of both the septum and lobules of the subcutaneous layer of the skin.
Panniculitis is an important feature of CL that must be differentiated from other diseases that can simulate CL such as chronic skin infections, Discoid lupus erythematosus, and cutaneous lymphoma.
皮肤利什曼病（CL）是由利什曼原虫引起的一种寄生性皮肤感染。其组织病理学本质上通常为肉芽肿性。
本研究旨在阐明CL的组织学特征，并评估受累患者中脂膜炎的存在情况及发生率。
病例系列干预性研究。
2012年12月至2013年5月期间，35例临床诊断为CL的患者。通过涂片、培养及聚合酶链反应（PCR）进行诊断确认。进行组织病理学评估以研究一般病理学特征并查找脂膜炎的存在情况。
通过SPSS 16.0版软件（SPSS公司，美国芝加哥）进行简单统计分析。
本研究纳入了18例女性和17例男性CL患者，疾病平均持续时间为3个月。诊断检测结果如下：涂片阳性21例（60%），7例（20%）患者可见利什曼-多诺万（LD）小体，培养阳性24例（68%），PCR阳性32例（91.4%）。表皮改变包括棘层肥厚、假上皮瘤样增生、溃疡、局灶性海绵形成及界面性皮炎，而真皮改变取决于疾病谱，因此在溃疡性病变中有淋巴细胞和组织细胞浸润，伴有浆细胞灶，有时可见LD小体聚集，而在干性病变中病理学主要为上皮样肉芽肿。16例（46%）病例可见脂膜炎，表现为皮肤皮下层间隔和小叶的弥漫性淋巴细胞和组织细胞浸润。
脂膜炎是CL的一个重要特征，必须与可模拟CL的其他疾病如慢性皮肤感染、盘状红斑狼疮及皮肤淋巴瘤相鉴别。
