A Histopathological study of cutananeous leishmaniasis in Sri Lanka
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Date
2010
Authors
Herath, C. H. P.
Ratnatunga, N. V. I.
Waduge, R.
Ratnayake, P.
Ratnatunga, C. N.
Ramadasa, S.
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Abstract
Abstract
Introduction Cutaneous leishmaniasis is endemic in Sri Lanka. The immunopathogenesis of these lesions in Sri Lankans has not been documented.
Objectives
To classify skin lesions into histological groups, to assess parasitic load, density of each inflammatory cell type and necrosis and to characterise the lymphocytic reaction in cutaneous leishmaniasis in comparison to leprosy.
Methods
Skin biopsies from 31 patients with demons- trable amastigotes in smears or tissue sections were studied. The lesions were classified by two independent observers into four distinct histological groups based on different cell types in the inflammatory infiltrate and formation of granulomata. Parasitic load and the presence of necrosis were recorded. Immunohis- tochemical staining for CD45RO and CD20 for counting T and B cells respectively was done.
Results
Histological groups of cutaneous leishmaniasis ranging from group I-IV were similar to that of the spectrum in leprosy ranging from lepromatous to tuberculoid leprosy. The histological groups from I-IV showed a significant inverse relationship with the mean parasitic index.
Necrosis was not a prominent feature. The mean percentage of T cells in the histological spectrum from group I-IV in leishmaniasis was similar to the spectrum from lepromatous to tuberculoid leprosy. Mean per- centage of T cells were 20.1% in group I, 20.5% in group II, 33.8% in group III and 47.8% in group IV. Lepromatous, borderline tuberculoid and tuberculoid leprosy had 21.3%, 33.4% and 48.0% T cells respectively.
Conclusion
Cutaneous leishmaniasis is a spectral disease similar to leprosy. The mean percentage T cells from group I-IV were similar to those in the spectrum of leprosy and mean percentage B cells varied in a narrow range
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Keywords
Cutaneous Leishmaniasis , Histopathology
Citation
Ceylon Medical Journal, Vol. 55, No. 4, 2010 pp. 106-111