Correlation of clinical, histopathological, and microbiological findings in 60 cases of cutaneous leishmaniasis.
BACKGROUND
In an endemic area, cutaneous leishmaniasis (CL) is largely diagnosed by its clinical appearance. Diagnostic challenge arises when the lesions appear in nonendemic area, when clinical picture is distorted, or any atypical variant is seen even in endemic regious. In developing countries like ours, the laboratory aid is not widely available and dermatologists mostly have to rely on clinical experience.


OBJECTIVE
The study was aimed to see the correlation of clinical, histological, and microbiological findings in clinically diagnosed cases of CL.


METHODS
It was an observational and descriptive study and was conducted over a period of 2 years in two dermatology centers in the country. Seventy-seven patients with clinically suspicious lesions of CL were screened and 60 of these were diagnosed as true clinical cases on the basis of criteria for clinical diagnosis. These cases were then subjected to slit skin smear and histopathological examination. Parasitologically positive and suggestive cases were recorded and descriptive statistics were used to evaluate the findings.


RESULTS
Out of 60 registered cases, 36 (60%) were smear-positive and 30 (50%) demonstrated Leishman Donovan (LD) bodies in histological sections. Twenty-six of the remaining (parasite-negative) cases showed one of the recognizable histological patterns seen in CL, 3 did not reveal any suggestive histology but responded to antimonial compound, and 1 turned out to be a case of deep mycosis.


CONCLUSIONS
Considering the magnitude of the problem and limited resources of a developing country like ours, clinical diagnosis alone may be reliable enough in endemic areas.
Combined Military Hospital, Muzaffarabad, Pakistan. albariul@yahoo.com
Arfan
A
ul Bari
Simeen
S
ber Rahman
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology