title: Clinicopathological evaluation of cutaneous leishmaniasis in the mediterranean region of Turkey.
abstract: OBJECTIVE
  Cutaneus leishmaniasis, a chronic self-limited disease of the skin, is usually caused by Leishmania Tropica. It is endemic in Southeastern Anatolia. The definitive diagnosis depends on demonstration of the parasites by smear and culture or its identification in tissue section. This study aimed to evaluate clinical and histopathological skin lesions in cutaneous leishmaniasis cases in Antalya, Turkey.
  
  
  METHODS
  Our study included 28 patients diagnosed with cutaneous leishmaniasis at the Pathology Department of Akdeniz University Medical Faculty. Histopathological sections were stained with Haematoxylin-Eosin, Giemsa or Leishman for visual examination of cellular components by two dermatopathologists. The epidermal (acanthosis, hyper-parakeratosis, atrophy, lymphocytic exocytosis) and dermal changes that may indicate lymphohistiocytic infiltration and granuloma formation were investigated. The parasitic load was classified according to the modified Ridley's parasitic index.
  
  
  RESULTS
  Out of 28 cases, 11 had hyperparakeratosis, 17 had orthokeratosis, 20 had acanthosis, 4 had epidermal atrophy, and 7 had exocytosis. Typical epithelioid cell granulomas with giant cells and a rim of lymphocytes were present in 16 cases. Leishman-Donovan bodies were extremely rare in typical granulomatous lesions. The other 12 cases showed lymphohistiositic infiltration, giant cells and prominent plasma cells. There were numerous Leishman-Donovan bodies in these lesions.
  
  
  CONCLUSIONS
  We investigated the epidermal and dermal changes that would facilitate the histopathological diagnosis of cutaneous leishmaniasis in this study. We found that atrophy, acanthosis, and orthokeratosis were early stage indicators, while exocytosis, hyperparakeratosis, and atrophy were indicative of late stage disease.
authors.affiliation: Department of Pathology, Akdeniz University, School of Medicine, ANTALYA, TURKEY.
authors.forename: Cumhur İbrahim
authors.initials: Cİ
authors.lastname: Başsorgun
authors.forename: Betül
authors.initials: B
authors.lastname: Ünal
authors.forename: Ayşe Akman
authors.initials: AA
authors.lastname: Karakaş
authors.forename: Erkan
authors.initials: E
authors.lastname: Alpsoy
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Çiftcioğlu
authors.forename: Soner
authors.initials: S
authors.lastname: Uzun
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D008297:Male; D059208:Parasite Load; D012867:Skin / Q000469:parasitology / Q000473:pathology*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult