Concordance of acid-fast stain result and histopathologic vs clinical diagnosis of leprosy: A three-year retrospective study in a Tertiary Government Hospital and Sanitarium in the Philippines

Objectives@#In the Philippines, there has been a lack of information on the concordance between classifications of Hansen’s disease or leprosy clinically, histopathologically, and with AFS results. The study ultimately aimed to determine the concordance between the clinical diagnosis, histopathological results, and AFS results of patients with leprosy seen at the Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium (DJNRMHS). @*Methods@#This is a descriptive, retrospective, single-center study conducted at the DJNRMHS, a tertiary government hospital and one of the last remaining sanitaria in the country located in northern Metro Manila in the Philippines. The study reviewed and included all the patient records from the years 2017-2019 which included skin biopsy results and slit-skin smear with AFS. Leprosy patients were then classified based on the following classifications: World Health Organization (WHO) and Ridley-Jopling classifications; and the concordance of clinical diagnosis vs the histopathologic findings and clinical diagnosis vs AFS results were determined using kappa testing.

Diagnostic usefulness of triple biopsies (Skin, Muscle and Nerve) in clinically suspected cases of vasculitis in a tertiary care hospital in Gujarat

Introduction: The term vasculitis refers to a heterogeneous group of diseases, all characterized by inflammation and destruction of blood vessel walls leading to ischemic, thrombotic, and hemorrhagic damage to tissues of central and peripheral nervous system. The main indication for triple biopsy (skin, muscle and nerve) is to rule out peripheral vasculitis neuropathy. However, the drawback is that any systemic inflammatory process may show changes in a skin biopsy and hence these changes need to be interpreted with caution. The aim of this study is to establish the diagnostic yield and the usefulness of the triple biopsies in clinically suspected cases of vasculitis. Material and Methods: The present study was conducted in the Department of General Pathology, SBKS MI & RC, Vadodara over a period of one year (1/1/2022 to 31/12/2022). All the clinically suspected cases of vasculitis received at OPD were included in the study. Any case with either muscle, nerve or skin biopsy reported as inadequate were excluded from the study. Results: On evaluation the usefulness of triple biopsies for vasculitis, we found a very low diagnostic yield with only 3.3% of peripheral nerve biopsy and 0.8% of muscle and nerve biopsy showed definite vasculitis. In case of suspected peripheral/systemic vasculitic neuropathy, nerve biopsy was sufficient in the majority of case and has the diagnostic armamentarium for the evaluation of vasculitis. Conclusion: In conclusion, nerve biopsies provide the best yield for the diagnosis of vasculitis, as opposed to muscle and skin biopsies. The role of triple biopsies as a routine protocol for the evaluation of vasculitis is questionable.

Urticaria pigmentosa in a 9‐month‐old male: case report

@#Urticaria pigmentosa (UP) is the most common form of cutaneous mastocytosis in children. It can be diagnosed clinically, based on the appearance of numerous brownish macules and papules that are symmetrically distributed, mostly on the trunk and the extremities. Skin biopsy is helpful in establishing the diagnosis. Treatment options generally include antihistamines and/or topical corticosteroids. In most cases, pediatric UP tends to disappear spontaneously before puberty. We present the case of a 9-month-old male with a history of multiple brownish patches and plaques, which started when he was four months old. He was diagnosed with UP based on clinical and histopathologic findings, and was prescribed oral antihistamines and emollients for symptomatic treatment.

CLINICO- PATHOLOGICAL STUDY OF VARIANTS OF CUTANEOUS LICHEN PLANUS

INTRODUCTION Lichen planus is a common but, unique in?ammatory disorder with distinctive clinical presentation in the form of prototypic “lichenoid” papules that show peculiar colour and morphology, develop in typical locations, manifest characteristic patterns of evolution and histopathological features. The current study was aimed to study the clinical and histopathological patterns of variants of cutaneous lichen planus. The study METHODOLOGY was carried out in the Department of Pathology, Jhalawar medical college, Jhalawar, and the cases received in the duration of 5 years from October 2016 to October 2021 were included in the study. Patients' demographic details and clinical data in terms of duration, number, type, color, site of lesions and other associated symptoms were noted. Epidermal and dermal changes were noted on histopathology (H & E stained skin biopsies). 73 cases of lichen planus were studied and classical lichen RESULT planus was the most common variant observed. Other variants were lichen planus hypertrophicus, atrophicus, pigmentosus, follicularis, actinic and linear. Most patients were in 3rd and 4th decades of life, slight female predominance was noted. Clinically lesions were mostly pruritic with violaceous papule formation. Most patients presented within 1 to 6 months of duration and lower extremities were most common site involved. Histopathologically basal vacuolation and band like in?ltration were consistently seen features. Clinico- pathological correlation was seen in 95.89% cases. Lichen CONCLUSION planus is a common, chronic papulosquamous disorder and with dual approach of clinical and histopathological examination, an early and precise diagnosis can be made that will help patients receive timely treatment and reduce morbidity and risk of malignant transformation.

Histopathological spectrum of chronic skin ulcers in a tertiary care hospital

Background:The skin is the largest organ of the body, comprising of epidermis, dermis and hypodermis. Thus, a wide range of diseases can develop from the skin ranging from infectious diseases to malignancy, some of which may present as non-healing ulcers. Skin biopsy forms the fundamental basis for differentiation of similar looking lesions, thus helping the pathologists to make a definitive diagnosis and more so to the clinician for better management of patients. The objective was to study the histopathological spectrum of chronic non healing ulcers of skin for proper management and treatment.Methods:This was a hospital-based study which was conducted in SKIMS,Soura, a tertiary care hospital of Kashmir valley for a period of 1year extending from January 2018 to December 2018. All the patients who presented with the complaint of non-healing ulcer for more than 4 to 6 weeks were subjected to skin biopsy and histopathological examination.Results:A total of 260 biopsies were examined. Out of 260 patients 146 were males and 114 were females. Ninety out of 260cases (34.61%) and 170 (65.39%) were diagnosed as malignant and benign ulcers respectively.Diabetic ulcer was the second most common cause ofnon-healing ulcers followed by bacterial infections and tuberculosis. Squamous cell carcinoma was the most common neoplastic pathology. Conclusions: It was concluded from the study that non-healing skin ulcers can be encountered at any age in daily medical practice

Clinicopathological correlation in leprosy

Background: Leprosy is a chronic granulomatous disorder that is caused by Mycobacterium leprae. It mostly affects skin and peripheral nerves. The disease has varied clinical and pathological manifestations depending on the immune response of the patient. Histopathology helps in confirming the diagnosis for clinically suspicious cases and helps in exact typing which, in turn, influences treatment plan. Objectives: The objectives of this study were to study the incidence of different subtypes of leprosy and to evaluate the correlation of clinical subtype with the histopathological subtype. Materials and Methods: This was a cross-sectional comparative study done over a period of 1.5 years from August 1, 2017, to January 31, 2019, of skin biopsies of patients newly diagnosed with leprosy using routine and special stains along with clinicopathological correlation. Results: A total of 41 patients were studied between 11 and 80 years of age with a mean age of 32.64 years. Male-to-female ratio was 1.56:1. The majority of patients (41.46%) belonged to the age group of 21–30 years. Histopathologically, tuberculoid leprosy (19.51%) was the most common type followed by lepromatous leprosy and erythema nodosum leprosum (17.07% each). Clinical and histopathological concordance was seen in 65.8% of cases. The concordance was highest (100%) in histoid leprosy, indeterminate leprosy, and Type 1 lepra reaction. The most common presenting lesion was a hypopigmented macule (41.46%) followed by nodules (29.26%). Fite-Faraco positivity was 41.46%. Conclusion: Cumulative clinical, histopathological, and bacteriological diagnoses help in accurate typing of leprosy, thus facilitating appropriate therapy to prevent complications.

Direct immunofluorescence findings in cicatricial alopecia: A retrospective study of 155 cases

Objectives: To study the direct immunofluorescence (DIF) in cicatricial alopecia (CA) patients. Materials and Methods: Approximately, 155 skin biopsies from CA patients examined over 7 years (2009–2015). Special stains and Hematoxylin and Eosin were performed, and final histopathological diagnosis was made. DIF (against anti-IgG, IgM, C3, IgA, and fibrinogen) on all these cases and patterns were noted. The descriptive statistics were applied along with ANOVA test. Results: Approximately, 155 patients with Male: Female = 1.24:1, age 7–65 years. In total, 57 cases were of Lichen planopilaris (LPP; 36.7%), 22 Lichen planus (LP; 14.2%), 22 Psuedopalade of Brocq (PPB; 14.2%),16 discoid lupus erythematosus (DLE; 10.3%), 8 end-stage scarring alopecia (ESSA; 5.2%), 2 cases each of Fungal folliculitis (FF), and Folliculitis decalvans (FD; 1.3% each), and in 26 cases, no specific diagnosis could be reached were collectively kept in the category of non-specific findings (NSP; 16.7%). On DIF: LPP positive for IgG = 4 cases (7%), IgM = 26 (45%), IgA = 11 (19.3%), C3 = 16 (28.1%), and fibrinogen = 11 (19.3%). LP positive for IgG = 2 (9%), IgM = 18 (81%), IgA = 2 (9.1%), C3 = 10 (45%), and fibrinogen = 1 (4.5%). DLE positive for IgG = 6 (37%), IgM = 8 (50%), IgA = 1 (6.3%), C3 = 9 (56%), and fibrinogen = 1 (4.5%). Limitations: Because this was a retrospective study, clinical follow-up and treatment history of the patient could not be retrieved. Conclusions: IgG positivity helps significantly in differentiating LPP from DLE (P 0.004) and NSP from DLE (P 0.005). IgM positivity helps significantly in differentiating LPP from LP (P 0.04), LP from PPB (P 0.00) and NSP (P 0.00). C3 positivity helps significantly in differentiating PPB from DLE (P 0.02).

Clinical Evaluation for Diabetic Neuropathy / 대한신경근육질환학회지

Diabetic polyneuropathy (DPN) causes neuropathic pain with reduced quality of life as well as diabetic foot ulceration which sometimes resulted in amputation. Early detection and improved knowledge of pathogenic pathways are important to prevent and to manage DPN. The screening methods and several tests to diagnose DPN-quantitative sensory testing, skin biopsy, corneal confocal microscopy, etc.-will be described.

Role of S-100 Immunostaining in Differentiation of Borderline Leprosy from Other Granulomatous Diseases of Skin

Leprosy is a chronic granulomatous disease affecting skin, peripheral nerves and other tissues. On histopathology leprosy mimics other infectious and non-infectious lesions like tuberculosis, sarcoidosis and fungal infections, which are also common in our country. In tuberculoid and indeterminate forms, where Acid Fast Bacilli cannot be demonstrated, the diagnosis becomes more difficult. Mycobacterium leprae is the only bacterium which has the ability to infiltrate peripheral nerves leading to Schwann cell disintegration. On routine Hematoxylin and Eosin stains (H&E), the nerve fibers may not be easily identifiable in some cases , hence S-100 immunostaining is used to highlight the nerve elements and to demonstrate and compare the nerve changes in spectrum of leprosy. With widespread use of multi-drug treatment, there has been changes in the profile of disease. The aim of the present study was to observe different patterns of cutaneous nerve involvement in leprosy and to correlate these with the clinical and histopathological findings in currently referred cases for histopathological opinion. The study was conducted in the Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, over a period of 12 months (July 2016 - July 2017) Subjects were recruited from patients presenting in Dermatology OPD. A total 35 consecutive cases with clinical suspicion / diagnosis of leprosy were included in the study. Biopsies were processed and stained by H&E, Fite-Faraco as well as S100 immunostaining. It was observed that on S-100 immunostaining, 43.7% cases showed granulomas infiltrating the dermal nerves whereas these changes could not be demonstrated in 16.6% cases of Borderline leprosy on H&E staining alone. Thus S-100 staining appears to serve as an important tool to diagnose leprosy from other granulomatous diseases of skin even in current scenario of leprosy.

Direct Immunofluorescence Profile Of Lichen Planus - A Fresh Look On Old Disease. A Study Of 15 Cases

Introduction: Lichen planus (LP) is a chronic inflammatory mucocutaneous diasease that is often diagnosed on the basis of clinical &/or histopathologic findings. However, it has some characteristic direct immunofluorescence (DIF) findings that can help in diagnosing confusing cases.Aim:We analyzed DIF findings in skin biopsy in LP compared to histopathology. Materials & methods: A skin biopsy of lesion was taken from 15 cases of LP(13 classic LP & 2 LP pigmentosus) & subjected to histopathology & DIF examination. Results:The sensitivity of histopathology and DIF was found to be 100% & 93.3% respectivelyfor the diagnosis of LP & LPP.

Diagnostic Biopsy Site in Cutaneous Angiosarcoma: Reflections from 3 Cases

Angiosarcoma is a rare, malignant vascular endothelium neoplasm with poor prognosis. Cutaneousangiosarcoma makes up a majority of its presentation. Diagnosis is often delayed due to the nature ofits clinical presentation. We report 3 cases of cutaneous angiosarcoma to focus on the importance ofbiopsy site selection in securing the histopathological diagnosis.

The Delivery Rates of Pathology Test Results to Patients: A Single-Center Experience in a Secondary Referral Center

BACKGROUND: Delivery of pathology reports to the patient is a key step in the biopsy pathway, which is important for patient safety in dermatology. Automated systems for facilitating such medical process began in 2010 in our hospital, sending short message service to scheduled patients. OBJECTIVE: The purpose of this study was to evaluate the delivery of pathology reports to patients and investigate factors that influence this process and annual trends. METHODS: We retrospectively reviewed the medical records of all outpatients (n=2,452) who underwent skin biopsy at our department of dermatology in 2009 and 2014. In each year group, we analyzed the proportion of revisiting patients in terms of year, sex, age, season, biopsy method and diagnosis. RESULTS: In 2009, a smaller proportion of patients (205; 91.5%) who had undergone shave or excisional biopsy than of those who had undergone punch biopsy returned (781; 98.0%; p<0.001). This trend was not significant in 2014. Whereas there was no significant difference of return visit ratio between men and women in 2009, a higher proportion of women (754; 98.0%) than men (633; 95.6%) re-visited after skin biopsy to confirm their diagnosis in 2014 (p=0.008). Three patients with either a malignant tumor or suspected malignant lesion that required complete excision did not return to our clinic. CONCLUSION: Pathology report delivery rates were fairly satisfactory, regardless of year, age, season, and diagnosis. Sex and biopsy method influenced the return visit ratio. More organized follow-up protocols are required to strengthen patient safety and prevent critical patient drop-out.

A study of clinical and histopathological correlation of lichen planus

Introduction: Lichenoid tissue reaction or interface dermatitis embraces several clinical conditions, the prototype of which is lichen planus and its variants. Others include drug induced lichenoid dermatitis, special forms of lichenoid dermatitis, lichenoid dermatitis in lupus erythematosus, and other disorders all of which have salient clinical and histological features. The aim of this study was to correlate the clinical features with histopathological findings in all clinically suspected cases of lichen planus and assess the clinical diagnostic accuracy. Materials and methods: This study had been carried out over a period of 2 years from July 2015 to June 2017 in the Department of Pathology, Gandhi Hospital. Histopathological sections of skin biopsies from 85 patients were studied after routine H and E staining and morphological changes were noted. The patients’ clinical findings were then correlated with the histological changes. The results were then analysed. Results: Total numbers of biopsies inclusive of LP and LP like lesions were 85. Among them, the number of patients having LP was 50. The age ranged from 18 to 65 years (mean 37.1 years). The mean duration of the lesion was 12.02 months (approx 1 year). Males were affected more than females. Out of the 85 cases, 50 were Lichen planus and 35 were lichenoid eruptions. Of the Lichen planus, 31 (61.6%) cases were of classical lichen planus, 6 (13.3%) cases were of hypertrophic lichen planus, 4 (8.3%) cases were of lichen planus pigmentosus, 4 (6.6%) cases were of actinic lichen planus, 3 (5%) cases were of eruptive lichen planus, 1 (1.6%) case each of atrophic lichen planus, annular lichen planus. N. Srivani, B.V.N. Sravani, Shyamala Srujana, O. Shravan Kumar. A study of clinical and histopathological correlation of lichen planus. IAIM, 2017; 4(9): 136-144. Page 137 Conclusion: In the present study, maximum number of cases occurred in age group of 18-28 years. Though pruritis is a common symptom, it is nonspecific. Therefore, histopathology remains the most important diagnostic tool for proper evaluation of Lichenoid eruptions/ Lichen planus.

Single dose amoxicillin induced toxic epidermal necrolysis A rare life threatening dermatological condition.

Toxic epidermal necrolysis is a severe cutaneous drug reaction, mainly involving skin and mucous membranes. We have presented here a case report of 16 year old female patient who was diagnosed with toxic epidermal necrolysis clinically as well as histopathologically. The patient presented with history of fever, oral cavity ulcer, skin lesions which were ill defined, erythematous macular with darker hemorrhagic centre. Skin biopsy showed full thickness necrosis of dermis, dermal-epidermal separation and paucity of upper dermal cellular infiltration. The patient was treated with intravenous immunoglobulins, low dose steroids and systemic antibiotics and the patient improved significantly. The main purpose of the case report was to emphasize that even one single dose of amoxycillin can induce a toxic epidermal necrolysis.

Cadasil - genetic and ultrastructural diagnosis: case report / Cadasil - diagnóstico genético e ultraestrutural: relato de caso

ABSTRACT Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary disorder which affects the cerebral vasculature due to mutations in the NOTCH 3 gene. The diagnosis may be established through genetic testing for detection of these mutations and/or by skin biopsy. We report a case of the disorder in a female patient, who presented recurrent transient ischemic attacks that evolved to progressive subcortical dementia. Neuroimaging disclosed extensive leukoaraiosis and lacunar infarcts. The genetic analysis for NOTCH 3 was confirmatory. The ultrastructural examination of the skin biopsy sample, initially negative, confirmed the presence of characteristic changes (presence of granular osmiophilic material inclusions [GOM]), after the analysis of new sections of the same specimen. The present findings indicate that negative findings on ultrastructural examinations of biopsy should not exclude the diagnosis of the disease and that further analyses of the sample may be necessary to detect the presence of GOM.

ABSTRACT Arteriopatia Cerebral Autossômica Dominante com Infartos Subcorticais e Leucoencefalopatia (CADASIL) é uma desordem hereditária que acomete a vasculatura cerebral devido a mutações no gene do NOTCH 3. O diagnóstico pode ser estabelecido através de testes genéticos para a detecção das mutações e/ou de biópsia de pele. É relatado um caso da desordem em paciente feminino, que apresentou ataques isquêmicos transitórios recorrentes, evoluindo para um quadro progressivo de demência subcortical. A neuroimagem mostrou extensa leucoaraiose e infartos lacunares. A análise genética para NOTCH 3 foi confirmatória. O exame ultraestrutural de biópsia de pele, inicialmente negativa, confirmou a presença de alterações características (presença de material granular osmiofílico [GOM]), após a análise de novos cortes do mesmo material. Os presentes achados indicam que achados negativos de exames ultraestruturais de biópsia não deveriam excluir o diagnóstico da doença e que análise adicional da amostra pode ser necessária para detectar a presença de GOM.

CLINICO – HISTOPATHOLOGICAL SPECTRUM OF CUTANEOUS VASCULITIS: A RETROSPECTIVE STUDY OF 62 CASES

Context: Cutaneous Vasculitis is the inflammation of vessel walls which leads to hemorrhagic or ischemic events. The histopathological classification of cutaneous vasculitis depends on the vessel size and the dominant immune cell mediating the inflammation. Object: We studied the etiological factors and clinico-pathological spectrum of patients with cutaneous vasculitis at a tertiary referral centre of north India. Design: Skin biopsies of all patients with clinically suspected cutaneous vasculitis presenting over 5 years, between 2009-2014 were reviewed. Cutaneous vasculitis was classified on the basis of etiology (primary or secondary), on the basis of size of vessel wall as well as on the dominant inflammatory cell infiltrating the vessels. Results: Over 5 years, 62 / 103 patients evaluated for vasculitic syndromes had histologically proven vasculitis. Clinically, vasculitis was primary (77.4%) or secondary (22.5%) to drugs, infections, underlying connective tissue diseases and malignancy. Neutrophilic (n=30), lymphocytic (n=18), eosinophilic (n=10), and granulomatous (n=4) vasculitis were the major histopathological groups. Small vessel involvement was seen in 97% cases. Conclusion: Skin biopsy remains the gold standard for diagnosing cutaneous vasculitis. Small vessel vasculitis was the most common type of cutaneous vasculitis with the dominant cell type being neutrophilic. Eosinophilic infiltrate was exclusively associated with primary vasculitis.

Skin Biopsy: Emerging Method for Small Nerve Fiber Evaluation / 대한임상신경생리학회지

Skin biopsy with investigation of small nerve fiber in human epidermis and dermis has been proven to be a useful method for demonstration of small fiber neuropathy. Quantification of intraepidermal nerve fiber density using anti-Protein Gene Product 9.5 (PGP 9.5) antibody is standardized method to diagnose the small fiber neuropathy. Skin biopsy method also makes it possible to differentiate the type of nerve fibers by using different antibodies. Quantification of dermal structures with different type of nerve fibers could be used to invest pathophysiologic mechanism of diseased state.

Biopsia por congelación: recomendaciones en la práctica clínica y dermatológica / Frozen biopsy: Recommendations in clinical and dermatology practice

Los avances en histotecnología han permitido a lo largo de los años el desarrollo de diferentes técnicas diagnósticas en la práctica de la patología. Entre estas técnicas se encuentra la biopsia por congelación, sin embargo, en el ámbito clínico es común el desconocimiento de esta herramienta diagnóstica. Presentamos una breve revisión acerca de sus limitaciones, sus posibles indicaciones y los casos en los que la biopsia por congelación brinda información importante al clínico para orientar una modificación terapéutica. Al final se hace énfasis sobre las consideraciones a tener en cuenta sobre la biopsia por congelación de piel y las condiciones clínicas en las cuales resulta útil.

The advances in histotechnology over the years have enabled the development of different diagnostic techniques in the pathology practice. These techniques include frozen biopsy; however, in the clinical field use of this diagnostic tool generally unknown. A brief review of their limitations are presented, along with their possible indications, as well as cases in which frozen biopsy provides important information to the clinician to guide therapeutic changes. Finally, emphasis is placed on the considerations to take into account in frozen skin biopsy, and the clinical conditions in which it is useful. © 2013 Instituto Nacional de Cancerología. Published by Elsevier España, S.L.U. All rights reserved.

Abordagem diagnóstica da dermatomiosite / Diagnostic approach to dermatomiositis

O Instituto Lauro de Souza Lima (ILSL) é um centro de referência dermatológica e a dermatomiosite é uma doença frequente em seu ambulatório. A dermatomiosite é identificada por suas lesões de pele específicas e pela presença de miopatia inflamatória. Sua incidência é baixa. A confirmação diagnóstica é realizada através da análise da apresentação dermatológica, dosagem sérica de enzimas musculares, eletroneuromiografia e biópsias de pele e músculo. Objetivo: analisar a incidência, características clínicas e procedimentos diagnósticos realizados bem como o tempo para o diagnóstico, levando em conta a sua efetividade. Método: estudo retrospectivo dos prontuários de pacientes diagnosticados com dermatomiosite de janeiro de 2000 a abril de 2013 no ILSL. Conclusão: aconselha-se que se dê prioridade ao atendimento de pacientes com os sintomas neurológicos mais sugestivos, tais como: fraqueza muscular e disfagia associadas a lesões de pele, tendo em vista a possibilidade de dermatomiosite.

As the Instituto Lauro de Souza Lima is a Dermatology Reference Center, dermatomyositis is prevalent in its outpatient clinic. Dermatomyositis is identified by its specific skin lesions and inflammatory myopathy and has low incidence. Diagnostic confirmation is made by the dermatological presentation, serum muscle enzymes, electroneuromyography and skin and muscle biopsies. Objective: to analyze the incidence, clinical features, diagnostic procedures and time to diagnosis of dermatomyositis patients, according to the algorithm rationality and effectiveness Methods: it is a retrospective surveillance of Instituto Lauro de Souza Lima (ILSL) patients from January 2000 until April 2013. Conclusion: in a dermatology outpatient department it is advisable to prioritize dermatological cases with neurological symptoms suggestive of dysphagia and muscular weakness with skin lesions, referring for neurological examination due to the possibility of derrmatomyositis.

Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees.

Background: The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL) in the city of Sanliurfa in Turkey, where Syrian refugees also reside. Materials and Methods: At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients’ medical records. All the slides of each patient were re-evaluated histopathologically. Results: Fiftyfour cases (mean age; 17 ± 12 years), consisting of 32 males (59.3%) and 22 females (40.7%), were examined. The most common site of involvement was the face (63%). The most common presentation was noduloulcerative lesions (57.4%). Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic infl ammatory infi ltration, leishmania amastigotes and non-caseating granulomatous infl ammation in the dermis. Conclusion: CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other infl ammatory and neoplastic diseases. The diagnosis of CL relies on the identifi cation of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.