The Investigation of the Association of Cutaneous Leishmaniasis in Biopsy Specimens of the Patients with Granulomatous Disease and Skin Cancer Using the Molecular Method

  • Gülnaz ÇULHA Department of Parasitology, School of Medicine, University of Hatay Mustafa Kemal, Hatay, Turkey
  • Asena Çiğdem DOĞRAMACI Department of Dermatology, School of Medicine, University of Hatay Mustafa Kemal, Hatay, Turkey
  • Sibel HAKVERDİ Department of Medical Pathology, School of Medicine, University of Hatay Mustafa Kemal, Hatay, Turkey
  • İlke Evrim SEÇİNTİ Department of Medical Pathology, School of Medicine, University of Hatay Mustafa Kemal, Hatay, Turkey
  • Özkan ASLANTAŞ Department of Microbiology, School of Veterinary Science, University of Hatay Mustafa Kemal, Hatay, Turkey
  • Ebru ÇELİK Department of Dermatology, School of Medicine, University of Hatay Mustafa Kemal, Hatay, Turkey
  • Tuğba KAYA Mail Department of Parasitology, School of Medicine, University of Hatay Mustafa Kemal, Hatay, Turkey
Keywords:
Cutaneous leishmaniasis, Granulomatous diseases, Skin cancer

Abstract

Background: Clinically, cutaneous leishmaniasis (CL) can be confused with granulomatous diseases and skin cancers, and it may lead to erroneous diagnosis and treatment. Diagnosis based and histopathology can have some difficulties due to low number of parasites, especially in chronic CL cases. We aimed to emphasize the necessity of considering CL in the differential diagnosis for cases of granulomatous diseases and basal cell carcinoma, particularly in areas where CL is endemic.

Methods:  One hundred and seven paraffin-embedded tissue biopsy specimens were selected from the archive, as of 2002, of Pathology Department, School of Medicine, University of Hatay Mustafa Kemal in Hatay, Turkey. After DNA isolation, performed with the samples were used for PCR analysis with specific 13A, 13B primers targeting kinetoplastid DNA (kDNA) found in all Leishmania species. Another PCR was performed with LITSR and L5.8S primers targeting ITS-1 internal-transcribed-spacer-1 (ITS-1) region to subtype positive samples. Then these samples were further analyzed for subtyping with PCR-RFLP using HaeIII enzyme (BsuRI).

Results: Ten out of 107 tissue specimens were positive via kDNA-PCR. Lupus vulgaris, sarcoidosis, skin lymphoma and Leishmania cutis appeared in 9 out of 10 positive specimens. One of the cases presented with a mass on the cheek and was pre-diagnosed with hemangioma, but leishmaniasis did not appear. All of 10 specimens were diagnosed as granulomatous dermatitis. Two out of 10 samples, found positive with kDNA-PCR, were analyzed with ITS-1-PCR and identified as L. infantum/donovani after RFLP.

Conclusion: Molecular methods should be utilized in the differential diagnosis of CL to eliminate false diagnoses of granulomatous diseases and skin cancers.

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Published
2020-09-12
How to Cite
1.
ÇULHA G, DOĞRAMACI A Çiğdem, HAKVERDİ S, SEÇİNTİ İlke E, ASLANTAŞ Özkan, ÇELİK E, KAYA T. The Investigation of the Association of Cutaneous Leishmaniasis in Biopsy Specimens of the Patients with Granulomatous Disease and Skin Cancer Using the Molecular Method. Iran J Parasitol. 15(3):307-314.
Section
Original Article(s)