[Clinical and histological study of lupoid cutaneous leishmaniasis (16 cases)]

Presse Med. 2007 Dec;36(12 Pt 1):1738-42. doi: 10.1016/j.lpm.2007.07.004. Epub 2007 Sep 6.
[Article in French]

Abstract

Introduction: Zoonotic cutaneous leishmaniasis (CL) is characterised by a major clinical polymorphism, especially the lupoid type. The aim of our study was to precise the anatomic and clinical particularities of this clinical form of CL.

Materials and methods: The present work was a prospective 1-year study. In all patients, the epidemiologic and clinical characteristics were identified, together with those regarding disease progression. Standard cutaneous biopsies were carried out for all study patients.

Results: The lupoid form was observed in 15% of the patients. It was clinically characterised by a lupoid aspect with papular and squamous placard surrounded by a satellite papule, a short duration of disease progression (28 months in average) and a preferential localisation at the level of the face and the elbow, statistically proven. At the histological level, epidermic hyperplasia was found in 93.8% of the cases; an inflammatory polymorphic dermic infiltrate consisting of lymphocytes and plasmocytes was found in all patients; granulomas were noted in 50% of the cases, and isolated epitheloid cells were observed in the derm of 3 patients. Amastigotes were rarely observed.

Discussion: In our series, the lupoid form was characterised with a short and non chronic evolution and two preferential sites for the affection: the face and the elbow. At the histological level, the lupoid type of CL appeared characterized by a high frequency of granuloma, usually organized, and rare amastigotes. However, the histology of authentic lupoid forms can be non granolomatosic.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antimony / therapeutic use
  • Antiprotozoal Agents / therapeutic use
  • Biopsy
  • Child
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Leishmaniasis, Cutaneous* / diagnosis
  • Leishmaniasis, Cutaneous* / drug therapy
  • Leishmaniasis, Cutaneous* / pathology
  • Male
  • Meglumine / administration & dosage
  • Meglumine / therapeutic use
  • Meglumine Antimoniate
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use
  • Middle Aged
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / therapeutic use
  • Prospective Studies
  • Skin / pathology
  • Time Factors
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Metronidazole
  • Meglumine
  • Meglumine Antimoniate
  • Antimony