Yang Y, Guan L
Institute of Parasitic Diseases, Chinese Academy of Preventive Medicine, Shanghai.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 1994;12(3):182-4.
Clinicopathological observations on 28 cases of cutaneous leishmaniasis with dermal lesions for 1-48 months were carried out. The cutaneous lesions detected in the patients might be categorized into four types. 1. Papular eruption or plaque. It was predominated by inflammatory reaction, including numerous leishmanias and macrophages and other inflammatory cells infiltrating in cutaneous tissue. 2. Soft node or abscess. It was composed of necrotic tissues, many degenerated and dead leishmanias as well as disintegrated inflammatory cells in the focal site. 3. Ulceration. It contained necrotic cutaneous tissue, a considerable number of dead leishmanias and granuloma formation. 4. Hard nodule. Tissue proliferation and healing were distinct, which was indicated by the increase of fibroblasts and fibrous tissue formation, round cells infiltration as well as the foreign body giant cell appearance; besides, a few leishmanias existed; occasionally, scar formation was visible in the superficial and deep layers of the derma. The paper presented for the first time the histopathological changes of cutaneous leishmaniasis in China. And, the description of cutaneous lesions will be of significance in the differential diagnosis between cutaneous leishmaniasis and post kala-azar dermal leishmaniasis.
对28例皮肤利什曼病患者进行了为期1 - 48个月的皮肤病变临床病理观察。患者的皮肤病变可分为四种类型。1.丘疹或斑块。以炎症反应为主，包括大量利什曼原虫、巨噬细胞及其他炎症细胞浸润于皮肤组织。2.软结节或脓肿。由坏死组织、许多变性和死亡的利什曼原虫以及局部崩解的炎症细胞组成。3.溃疡。包含坏死的皮肤组织、相当数量死亡的利什曼原虫及肉芽肿形成。4.硬结节。组织增殖和愈合明显，表现为成纤维细胞增多、纤维组织形成、圆形细胞浸润以及异物巨细胞出现；此外，存在少数利什曼原虫；偶尔在真皮浅层和深层可见瘢痕形成。本文首次报道了中国皮肤利什曼病的组织病理学变化。而且，皮肤病变的描述对皮肤利什曼病与黑热病后皮肤利什曼病的鉴别诊断具有重要意义。
