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


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.


CONCLUSIONS
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.
Masmoudi
Abderrahmen
A
Service de dermatologie et de vénéréologie, CHU Hédi Chaker, Sfax, Tunisie. masmoudiabd@yahoo.fr
Boudaya
Sonia
S
Ayadi
Narjes
N
Bouassida
Samir
S
Khabir
Abdelmajid
A
Meziou
Taha Jalel
TJ
Akrout
Feryel
F
Sallemi
Tahia
T
Turki
Hamida
H
Zahaf
Abdelmajid
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000965:Antimony / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001706:Biopsy; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D012867:Skin / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome