The frequency of vascular changes in the histopathology of cutaneous leishmaniasis

Introduction: Cutaneous leishmaniasis (CL) is a parasitic skin infection which can bedebilitating. This study was performed to determine the vascular changes in thehistopathology of CL.Methods: Thirty-seven patients with CL were included in a prospective study. A 4 mmpunch biopsy was obtained from the border of the lesion. After histopathologic processingand H&E staining, it was reviewed by a pathologist. In addition, 285 cases of CL, whosebiopsy files were restored at the pathology ward, during a 23 year period, were reviewedfor the assessment of vascular changes. Immunoperoxidase staining for IgG and IgA wasalso performed on paraffin-embedded blocks.Results: Out of the 37 patients with CL, 64.7% were male and 35.3% were female. Inthis group, 73.5% had chronic and 26.5% had acute CL. The most common type oflesion was an ulcerated plaque. Of the total of 322 biopsy files that were reviewed, 34(10.5%) had vascular changes in their lesions. The vascular changes included moderate tosevere perivascular lymphocytic infiltration and severe perivascular lymphocyticinfiltration with obstruction or narrowing of vessels with or without destruction. A fewcases showed endothelial proliferation of blood vessels and one case had leukocytoclasticvasculitis.Conclusion: CL should be considered in the differential diagnosis of chronic cutaneousulcers in endemic areas, which demonstrate vascular changes or vasculitis in theirpathology. Severity of the disease may be due to the underlying intense localinflammatory reaction, manifested as lymphocytic vasculitis.

Keywords:

Cutaneous , Leishmaniasis , Vascular Changes , Histopathology