Evaluation of the existence of leishmania DNA in chronic granulomatous dermatitis with PCR

Introduction: Chronic granulomatous dermatitis is seen in states like foreign body granuloma, fungal infections, sarcoidosis, leishmaniasis, Tuberculosis, cat-scratch disease, leprosy and Brucellosis. It is therefore essential that in cases of granulomatous dermatitis with unknown etiology, infectious agents be ruled out by culture, especial staining or PCR, but in practice in our area due to endemicity of leishmaniasis in cases with clinical suspicion of leishmaniasis, negative smear and biopsy showing granulomatous inflammation, if PPD and Ziehl -Nelsen staining are negative , patients empirically will be treated for leishmaniasis. In this study, our aim was to evaluate the presence of leishmania by PCR in samples of non-specific granulomatous dermatitis. Procedure: 64 samples of granulomatous dermatitis with unknown etiology which were negative in reviewing in terms of fungal elements, mycobacterial, Leishman body with specific staining and no foreign body was existed in reviewing by polarized microscopy, were selected from pathology department achieve, Imam Reza Hospital during 2009- 2013. After removing paraffin and extracting DNA, samples were evaluated for the presence of Leishmaniasis by method of PCR. Results: In this study on 64 patients with granolumatous dermatitis with unkown etiology 10.5% of samples were positive for Leishmaniasis by PCR, including 2 Leishmania Tropica and 5 Leishmania Major. 5 people were females and 2 males. 5 lesions were in the face - neck and 2 lesions were in upper limb. 5 cases were tuberculoid granuloma and 2 cases were supurative granuloma. Statistically, there is no significant correlation between the results of PCR and type of granuloma, patients’ age, sex and location of the lesions. Conclusions: Based on the results of this study in endemic areas for Leishmaniasis in dealing with granulomatous dermatitis with unkown etiology, especially in cases with tuberculoid granulomas with plasma cell and pseudoepiteliomatous hyperplasi in pathologic evaluation , it is better to perform PCR for leishmania DNA.

Keywords:

PCR , Leishmaniasis , and granulomatous dermatitis