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Presse Med ; 36(12 Pt 1): 1738-42, 2007 Dec.
Article in French | MEDLINE | ID: mdl-17825519

ABSTRACT

INTRODUCTION: 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. MATERIALS AND 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. DISCUSSION: 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.


Subject(s)
Leishmaniasis, Cutaneous , Adolescent , Adult , Aged , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Biopsy , Child , Disease Progression , Female , Follow-Up Studies , Humans , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Cutaneous/pathology , Male , Meglumine/administration & dosage , Meglumine/therapeutic use , Meglumine Antimoniate , Metronidazole/administration & dosage , Metronidazole/therapeutic use , Middle Aged , Organometallic Compounds/administration & dosage , Organometallic Compounds/therapeutic use , Prospective Studies , Skin/pathology , Time Factors , Treatment Outcome
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