title: Identification of parasite antigen, correlation of parasite density and inflammation in skin lesions of post kala-azar dermal leishmaniasis.
abstract: BACKGROUND
  Post kala-azar dermal leishmaniasis (PKDL) is an unusual dermatosis following kala-azar (KA). Demonstration of the amastigotes in lesions plays an important role in the diagnosis of PKDL. It was aimed to evaluate the utility of an antibody G2D10 in detecting leishmania parasite antigen, to correlate the parasite number/percentage of parasites with the inflammation, and to assess the epidemiological significance associated with the location of the parasites.
  
  
  METHODS
  The study was conducted on 50 cases. Hematoxylin and eosin (H & E) stains and immunohistochemical (IHC) stains, using G2D10 antibody, was performed on the skin biopsies. The number of parasites and density of inflammation were semiquantitatively assessed.
  
  
  RESULTS
  Leishmania donovan bodies (LDBs) were identified in 50% of cases with the H & E compared to 80% positivity with the IHC. All 50 cases showed inflammation in the superficial dermis (SD). About 44% showed dense inflammation compared to 16% sparse and 40% moderate inflammation. Parasite percentage was maximum in the SD (100%) compared to 75 and 42% in the mid and deep dermis, respectively.
  
  
  CONCLUSIONS
  The IHC showed a higher percentage of LDB localization (80 vs. 50%). Density of inflammation was maximum in the SD. The parasite percentage was correlated with the inflammation. Location of parasites could have an epidemiological significance.
authors.affiliation: Institute of Pathology, Safdarjang Hospital Campus, New Delhi, India. beena_ram.hotmail.com
authors.forename: K R
authors.initials: KR
authors.lastname: Beena
authors.forename: V
authors.initials: V
authors.lastname: Ramesh
authors.forename: Ashok
authors.initials: A
authors.lastname: Mukherjee
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000953:Antigens, Protozoan / Q000032:analysis*; D002648:Child; D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D005260:Female; D005456:Fluorescent Dyes; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007893:Leishmania donovani / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000276:immunology* / Q000469:parasitology; D007898:Leishmaniasis, Visceral / Q000150:complications*; D008297:Male; D013194:Staining and Labeling
chemical_list: D000953:Antigens, Protozoan; D004396:Coloring Agents; D005456:Fluorescent Dyes; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin