Abstract:
Leishmaniasis is a recently established disease in Sri Lanka, and patients
with cutane ous leishmaniasis (CL) have been reported in almost all districts.
Leishmania donovani has been identified as the causative organism. This
research is designed to study the clinical and histopathological features in
CL. The study was conducted on CL suspec ted patients attending the
Dermatology clinic in Base Hospital Tangalle from June 2016 to January
2017. After a general clinical examination, characteristic features of the CL
lesions were recorded using a structured clinical data sheet. A slit skin thin
smear taken from each patient was stained with Giemsa stain and examined
under the light microscope to identify Leishmania amastigotes. On the
subsequent clinic visit, skin biopsy samples were taken only from the slit
skin smear positive patients. Prepare d sections were stained with
Haematoxyline/Eosin to observe any histopathological changes. During this
study, forty five (45) skin biopsy samples were collected. Out of f our types
of lesions, the most common type was nodules. Majority of CL patients had
le sions on their upper arms (67.3%). Most of the lesions (57.1%) were
wider than 1 mm and lesser than 1 cm in size. Considerable number of
lesions was 3 to 6 months old. Dermal changes like mononuclear infiltrate
of lymphocytes, macrophages, plasma cells and a few giant cells were seen.
In lesions less than 6 months old, large number of L. Donovani (LD) bodies
could be seen but the LD bodies spread up to deeper layers of the skin when
the duration of the lesions increased. The most common epidermal changes
of these lesions were hyperkeratosis, parakeratosis and acanthosis. Current
findings indicate that the skin biopsy samples can be used for the diagnosis
of CL especially the old, ulcerative CL lesions by considering the epidermal
and dermal changes in histol ogical sections.
