Is slit-skin smear an alternate to histopathology in the diagnosis of cutaneous leishmaniasis?

Authors

  • Asher Ahmed Mashhood
  • Salman Ahmad
  • Muhammad Mumtaz Malik

Keywords:

Cutaneous leishmaniasis, slit-skin smear, histopathology, Leishman-Donovan bodies

Abstract

Objective To determine how effective is slit-skin smear as a diagnostic test in comparison with the histopathology. Methods This was a validation study, carried out in Combined Military Hospital (CMH) Kohat from 1st September 2011 to 30th June 2012. The study population was the patients who were clinically diagnosed as cutaneous leishmaniasis. Slit-skin smears were performed in all and a biopsy was sent for histopathology. The results were analyzed by cross tabs and chi square test.  Results A total of 50 patients were included. They were all adult males. Leishman-Donovan (LD) bodies were seen in histopathology slides in 31 patients (62%) and were not detected in 19 patients (38%). The slit-smear showed LD bodies in 18 smears (36%) and negative in 32 smears (64%) [p=0.048]. Conclusion Histopathology is statistically superior investigation than slit-skin smear in the diagnosis of cutaneous leishmaniasis. 

References

Ashford RW, Desjeux P, de Raadt P. Estimation of population at risk of infection and number of cases of leishmaniasis. Parasitol Today. 1992;8:104-5.

Gonzalez R, De Sousa L, Devera RJA, Ledezema E. Seasonal and nocturnal domiciliary human landing/biting behaviour of Lutzomyia (lutzomyia) evansi and Lutzomyia (Psychodopygus) panamensis (diptera; Psychodidae) in a periurban area of a city on the Caribbean coast of eastern Venezuela (Barcelona; Anzoategui State). Trans R Soc Trop Med Hyg. 1999;93:361-4.

Brandao-Filho SP, Campbell-Lendrum D, Brito ME et al. Epidemiological surveys confirm an increasing burden of cutaneous leishmaniasis in north-eastern Brazil. Trans R Soc Trop Med Hyg. 1999;93:488-94.

Herwaldt BL, Stokes SL, Juranek DD. American cutaneous leishmaniasis in U.S. travellers. Ann Intern Med. 1993;118:779-84.

Kalter DC. Cutaneous and mucocutaneous leishmaniasis. Progr Derm. 1989;23:1-11.

Lever WF, Schamberg-Lever G. Histopathology of the Skin. 7th edn. Philadelphia: Lippincott; 1990.

Evans D. Handbook on Isolation, Characterisation and Cryopreservation of Leishmania. Geneva: UNDP/World Bank/WHO(TDR); 1989.

Gilles HM, editor. Protozoal Diseases. London: Arnold; 1999.

Bryceson A. Therapy in man. In: Peters W, Killick-Kendrick R, editors. The Leishmaniases in Biology and Medicine. London: Academic Press; 1987. pp.847-907.

Berman JD. Chemotherapy for leishmaniasis: Biochemical mechanisms, clinical efficacy and future strategies. Rev Infect Dis. 1988;10:560-86.

Hepburn NC, Tidman MJ, Hunter JAA. Cutaneous leishmaniasis in British troops from Belize. Br J Dermatol. 1993;128:63-8.

Herwaldt BL, Berman JD. Recommendations for treating leishmaniasis with sodium stibogluconate (Pentostam) and review of pertinent clinical studies. Am J Trop Med Hyg. 1992;46:296-306.

Herwaldt BL, Arana BA, Navin TR. The natural history of cutaneous leishmaniasis in Guatemala. J Infect Dis. 1992;165:518-27.

Soto J, Toledo J, Gutierrez P et al. Treatment of American cutaneous leishmaniasis with miltefosine, an oral agent. Clin Infect Dis. 2001;33:e57-61.

WHO. Control of the leishmaniases. Technical report series 793. Geneva: WHO; 1990.

Uzun S, Uslular C, Yucel A et al. Cutaneous leishmaniasis: evaluation of 3074 cases in the Cukurova region of Turkey. Br J Dermatol. 1999;140:347-50.

Arevalo I, Ward B, Miller R et al. Successful treatment of drug resistant cutaneous leishmaniasis in humans by use of Imiquimod, an immunomodulator. Clin Infect Dis. 2001;33:1847-51.

Kubba R, Al-Gindan Y, El-Hassan AM, Omer AHS. Clinical diagnosis of cutaneous leishmaniasis (oriental sore). J Am Acad Dermatol. 1987;16:1183-9.

Rahman S, Bari A. Laboratory profile in patients of cutaneous leishmaniasis from various regions of Pakistan. J Coll Physicians Surg Pak. 2003;13:313-6.

Bari AU, Azam S, Ejaz A, Mahmood T. Comparison of various cytodiagnostic tests in the rapid diagnosis of cutaneous leishmaniasis. J Pak Assoc Dermatol. 2010;20:63-9.

Al-Hucheimi SN, Sultan BA, Al-Dhalimi MA. A comparative study of the diagnosis of Old World cutaneous leishmaniasis in Iraq by polymerase chain reaction and microbiologic and histopathologic methods. Int J Dermatol. 2009;48:404-8.

Sharquie KE, Hassen AS, Hassan SA, Al-Hamami IA. Evaluation of diagnosis of cutaneous leishmaniasis by direct smear, culture and histopathology. Saudi Med J. 2002;23:925-8.

Dar NR, Khurshid T. Comparison of skin smears and biopsy specimens for demonstration of Leishmania tropica bodies in cutaneous leishmaniasis. J Coll Physicians Surg Pak. 2005;15:765-7.

Khatri ML, Di Muccio T, Gramiccia M. Cutaneous leishmaniasis in North-Western Yemen: a clinicoepidemiologic study and Leishmania species identification by polymerase chain reaction-restriction fragment length polymorphism analysis. J Am Acad Dermatol. 2009;61:e15-21. Epub 2009 Aug 19.

el-Safi SH, Peters W, el-Toam B et al. Studies on the leishmaniases in the Sudan. 2. Clinical and parasitological studies on cutaneous leishmaniasis. Trans R Soc Trop Med Hyg. 1991;85:457-64.

Downloads

Published

2016-11-29

How to Cite

1.
Mashhood AA, Ahmad S, Malik MM. Is slit-skin smear an alternate to histopathology in the diagnosis of cutaneous leishmaniasis?. J Pak Assoc Dermatol [Internet]. 2016Nov.29 [cited 2024Mar.29];24(1):34-9. Available from: http://jpad.com.pk/index.php/jpad/article/view/171

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 > >>