clinical and Histopathological pattern of Diffuse Cutaneous Leishmaniasis: A six year retrospective study of a rare skin disease

Abstract

Background: Diffuse cutanous leishmaniasis(DCL) is a rare form of skin disease that is associated with defective cell mediated immunity. clinically, patients present with chronic often severe non-ulcerating nodules and plaques limited to the skin. Leishmanin test is usually negative despite abundant parasites in the skin. The disease responds poorly to treatment, has high rate of relapse and is associated with increase in morbidity and mortality.

Materials and methods: This is a six years retrospective study conducted between 1st January 2015-31st December 2020 among patients attending dermatology clinic of Usmanu Danfodiyo Universityt Teaching Hospital Sokoto. Relevent data were extracted from patients' case files and analused using SPSS 23.0 statistical software.

Results: Diffuse cutaneous leismaniasis was observed amon 6 patients: 3 females and 3 males. The mean age of the patients was 30.33 years(SD10.11)with a range of 22-48 yeras. Majority of the patirnts(83.3%)were HIV positive, while one patient(16.7%) was negative with aratio of 5:1 . The mean CD4  count among HIV positive patients was 46.25 cells/ml (SD 26.58) with a range of 24-81 cells. histology revealed expansion of the dermis and infiltration by numeours macrophages containing leishman-Donovan bodies in 60% of the patients.

Conclusion: This study revealed that DCL is not uncommon in this part of the worldespecially among patients with defective cellular immunity with very low CD4 count as seen in severe Acquired Immunodeficiency state.