The histopathology of cutaneous leishmaniasis due to Leishmania (Leishmania) mexicana in the Yucatan peninsula, Mexico

Abstract

Localized Cutaneous Leishmaniasis (LCL) known as "chiclero's ulcer" in southeast Mexico, was described by SEIDELIN in 1912. Since then the sylvatic region of the Yucatan peninsula has been documented as an endemic focus of LCL. This study of 73 biopsies from parasitological confirmed lesions of LCL cases of Leishmania (Leishmania) mexicana infection was undertaken: 1) to examine host response at tissue level; and 2) to relate manifestations of this response to some characteristics of clinical presentation. Based on Magalhães' classification we found that the most common pattern in our LCL cases caused by L. (L.) mexicana was predominantly characterized by the presence of unorganized granuloma without necrosis, (43.8%). Another important finding to be highlighted is the fact that in 50/73 (68.5%) parasite identification was positive. There was direct relation between the size of the lesion and time of evolution (rs = 0.3079, p = 0.03), and inverse correlation between size of the lesion and abundance of amastigotes (rs = -0.2467, p = 0.03). In view of the complexity of clinical and histopathological findings, cell-mediated immune response of the disease related to clinical and histopathological features, as so genetic background should be studied.

Preliminary study towards a novel experimental model to study localized cutaneous leishmaniasis caused bY Leishmania (Leishmania) mexicana

“…Type III and IV of Magalhaes' classification 21 have been found as the most common patterns in 21/73 (28.7%) and 32/73 (43.8%) respectively of our LCL cases caused by L. (L.) mexicana 5 .…”

“…Although a possible correlation between clinical and histological features has been examined to understand the immunological response in humans infected with L. (L.) mexicana 5 , it has been difficult to establish because such examination depends on a wide range of variables such as the host, the Leishmania species, the time of evolution at the moment of performing the histological study, the inoculation route and the dose of the parasite.…”

Atypical cutaneous leishmaniasis in the immunosuppressed

“…Two patients were on the anti-TNF adalimumab. The characteristic histology of CL shows intracellular non-flagellated amastigotes with a granulomatous inflammatory response 3. In both these cases histology failed to identify Leishmania parasites, however both were characterised by non-necrotising granulomas 4.…”

Eco-Epidemiological and Immunological Features of Localized Cutaneous Leishmaniasis in Southeastern Mexico: Thirty Years of Study

“…Parasite identification was positive in 68.5% of the biopsies. The size of the lesion was directly correlated with the time of evolution; however, an inverse correlation between the lesion size and abundancy of amastigotes was detected [14]. Therefore, the histopathology of LCL caused by…”