title: Characterization of the Histopathologic Features in Patients in the Early and Late Phases of Cutaneous Leishmaniasis.
abstract: Cutaneous leishmaniasis (CL), characterized by an ulcerated lesion, is the most common clinical form of human leishmaniasis. Before the ulcer develops, patients infected withLeishmania(Viannia)braziliensispresent a small papule at the site of the sandfly bite, referred to as early cutaneous leishmaniasis (E-CL). Two to four weeks later the typical ulcer develops, which is considered here as late CL (L-CL). Although there is a great deal known about T-cell responses in patients with L-CL, there is little information about the in situ inflammatory response in E-CL. Histological sections of skin biopsies from 15 E-CL and 28 L-CL patients were stained by hematoxilin and eosin to measure the area infiltrated by cells, as well as tissue necrosis.Leishmania braziliensisamastigotes, CD4+, CD8+, CD20+, and CD68+cells were identified and quantified by immunohistochemistry. The number of amastigotes in E-CL was higher than in L-CL, and the inflammation area was larger in classical ulcers than in E-CL. There was no relationship between the number of parasites and magnitude of the inflammation area, or with the lesion size. However, there was a direct correlation between the number of macrophages and the lesion size in E-CL, and between the number of macrophages and necrotic area throughout the course of the disease. These positive correlations suggest that macrophages are directly involved in the pathology ofL. braziliensis-induced lesions.
authors.affiliation: Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brazil.
authors.forename: Maíra G
authors.initials: MG
authors.lastname: Saldanha
authors.affiliation: Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brazil.
authors.forename: Adriano
authors.initials: A
authors.lastname: Queiroz
authors.affiliation: Serviço de Imunologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Paulo Roberto L
authors.initials: PRL
authors.lastname: Machado
authors.affiliation: Serviço de Imunologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil.|Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brazil.
authors.forename: Lucas P
authors.initials: LP
authors.lastname: de Carvalho
authors.affiliation: Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Phillip
authors.initials: P
authors.lastname: Scott
authors.affiliation: Serviço de Imunologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil.|Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brazil.
authors.forename: Edgar M
authors.initials: EM
authors.lastname: de Carvalho Filho
authors.affiliation: Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Bahia, Brazil.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Arruda
mesh_terms: D000328:Adult; D001938:Brazil; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000469:parasitology / Q000473:pathology; D007892:Leishmania braziliensis / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000473:pathology*; D008297:Male; D012867:Skin / Q000469:parasitology / Q000473:pathology; D012883:Skin Ulcer / Q000469:parasitology / Q000473:pathology*; D012959:Socioeconomic Factors