Role ofLeishmaniaspp. infestation in nondiagnostic cutaneous granulomatous lesions: report of a series of patients from a Western Mediterranean area

Abstract

Leishmania infection seems to be an important aetiological factor in cutaneous granulomatous lesions showing nondiagnostic features in endemic areas. In such areas, Leishmania-specific PCR amplification and/or immunohistochemical studies may be useful diagnostic tools. These techniques may be specifically indicated in the evaluation of patients showing nonspecific granulomatous inflammatory infiltrates of unknown aetiology lacking the histopathological evidence of parasites.

Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

“…Inclusion within the cytoplasm of histiocytes seen in H&E staining may suggest Leishmania; however, other organisms must be considered such as Histoplasma and Toxoplasma. ML can be difficult to diagnose, even when clinically active, because amastigotes usually are scarce and they may not be seen in both H&E and Giemsa stains [17]. Although few cases of oral leishmaniasis without skin lesions have been reported, the majority of them had no difficulties in establishing the diagnosis.…”

Cutaneous Leishmaniasis Mimicking A Pyogenic Granuloma

“…PCR is a decisive and accurate diagnostic technique despite the fact that it is difficult to perform and its success depends on the stage of the disease (7). As the lesion progresses, the number of amastigotes per microscopic field decreases and histological features are more similar to chronic LC, predominating a granulomatous tuberculoid pattern without nodular/diffuse necrosis (8). In 1980, Ridley (9) proposed 5 different groups by histological response: (i) histologically normal skin with areas of collagen degeneration, (ii) dermal necrotizing process, (iii) diffuse dermal inflammatory infiltrate, (iv) scarce Langerhans' giant cells and epithelioid histiocytes and (v) properly formed epithelioid granulomas.…”

Sensitivity of PCR and real-time PCR for the diagnosis of human visceral leishmaniasis using peripheral blood

“…PCR technology has been significantly refined, and realtime PCR now has advantages over traditional PCR, with shorter run times (because electrophoresis is no longer required) and reduced risk of contamination (because amplification can be detected while the tube is still closed) [23] . How does not show the various handling steps required after conventional PCR amplification reduces the risk of contamination of the material and allows, simultaneously, detecting, measuring and comparing the number of parasites in various samples [7,41] .…”

“…Real-time PCR has proven to be effective both in detecting Leishmania [22][23] and in quantifying parasite loads [24] .…”