Dimier-David L, Ravisse P, Bustillos R, Rollano F, Mallea F, David C, Lyèvre P, Valda L, Dedet J P
Instituto Boliviano de Biologia de Altura, La Paz.
Ann Dermatol Venereol. 1994;121(5):387-92.
A histopathological study of mucocutaneous leishmaniasis due to Leishmania (Viannia) braziliensis was carried out on 28 cutaneous and 114 mucosal biopsies, taken from Bolivian and Peruvian patients. This study showed similar histopathological findings in cutaneous and mucosal lesions. The cutaneous biopsies showed a strong epidermal hyperplasia occasionnally budding in the dermis. In the ulcerative area, the epidermis was totally necrosed and replaced by a fibrino-leucocytic edge. In the dermis, histio-lympho-plasmocytic infiltration was constantly found. The histiocytes often gathered in follicles sometimes with diffuse fibrosis. The parasites were encountered in 28.6 p. 100 of the biopsies. Whatever the mucosa concerned (i.e. nasal, palatal or lingual), the mucosal lesion was not different from the cutaneous lesion. The malpighian epithelium is either absent or the seat of a pseudo-epitheliomatous hyperplasia. Major histio-lympho-plasmocytic infiltration was found and extended through the depth of the lamina propria. Suppurative and fibrinoid necroses coexisted superficially and sometimes penetrated in depth. The parasites were found in about 30 p. 100 of the cases.
对28例皮肤活检样本和114例黏膜活检样本开展了一项关于巴西利什曼原虫（维安尼亚利什曼原虫）所致黏膜皮肤利什曼病的组织病理学研究，这些样本取自玻利维亚和秘鲁患者。该研究显示，皮肤和黏膜病变的组织病理学发现相似。皮肤活检样本显示有明显的表皮增生，偶尔在真皮层出芽。在溃疡区域，表皮完全坏死，被纤维蛋白-白细胞边缘取代。在真皮层，经常发现组织细胞-淋巴细胞-浆细胞浸润。组织细胞常聚集在毛囊中，有时伴有弥漫性纤维化。在28.6%的活检样本中发现了寄生虫。无论涉及何种黏膜（即鼻、腭或舌），黏膜病变与皮肤病变并无差异。马尔皮基上皮要么缺失，要么是假上皮瘤样增生的部位。发现有大量组织细胞-淋巴细胞-浆细胞浸润，并延伸至固有层深部。化脓性坏死和纤维蛋白样坏死在表面共存，有时深入到深层。在约30%的病例中发现了寄生虫。
