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. AIM: 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. CONCLUSION: 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.

Scar leishmaniasis

A large spectrum of clinical presentations of cutaneous leishmaniasis [CL] have been reported including a scar presentation in many chronic cases. We report here a case where CL developed in a scar of healed lesion of tuberculoid leprosy. Initially, it was suspected as a relapse or reaction of the previous disease, but on histopathology, it proved to be a new disease [CL]. On antileishmaniasis treatment, lesion healed satisfactorily in about a month time

Granuloma faciale: an unusual presentation

Granuloma faciale is a rare skin disorder, characterized by asymptomatic cutaneous nodules on the face without any systemic manifestations. The disorder mainly affects middle-aged Caucasian males. One such case occurring in a young unmarried lady of 'Pathan' descent is presented here. The presentation was unusual due to the history of frequent swelling, redness and heat in her nodules without any known stimuli and spontaneous regression of the nodules to the original size in a few hours. The patient was treated with a combination of cryotherapy and intralesional corticosteroids with excellent results