PCR-Based Diagnosis of Leishmania Species in Chronic Granulomatous Dermatitis in Mashhad, Iran
-
Yalda Nahidi
,
Naser Tayyebi Meibodi
,
Kiarash Ghazvini
,
Halime sadat Arabi Moghadam
,
Saeed Akhlaghi
,
Farnaz Torabian
Abstract
Background: Cutaneous leishmaniasis (CL) is a chronic granulomatous dermatitis (CGD). Approximately, 90% of CL patients are from seven countries including Iran. We explain polymerase chain reaction (PCR) diagnostic technique for chronic granulomatosis dermatoses including CL in Mashhad, Iran.
Methods: This study enrolled 64 patients within 2009-2013 with chronic granulomatosis dermatitis referred to dermatology and pathology departments of Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. We gathered demographic data from archived folders. Histological light microscopic evaluation and parasitological tests were done on selected specimens. We used PCR diagnostic test on specimens. Statistical analysis was done by SPSS version 15.
Results: Generally, 7 out of 64 specimens had Leishmania DNA and other samples had no Leishmania DNA. The mean age of patients was 46 ± 18.77 years; disease duration was 7 ± 6.73 months ranging from 1-24 months. Most of the lesions were located on face and upper limb. Totally, 5 out of 7 samples were Leishmania major and 2 out of 7 samples were L. tropica. Tuberculoid granuloma was present in L. tropica samples and 3 of L. major samples. Other light microscopic changes were as follow: 42 suppurative granuloma, and epidermal changes including atrophy, pseudoepitheliomatous hyperplasia, and parakeratosis with dermal changes including, plasma cell, involvement of papillary and reticular dermis, and distribution of granuloma to hypodermis.
Conclusion: Our results addressed PCR-based diagnosis of chronic cutaneous leishmaniasis, which is resulted from L. major and L. tropica.
1. Schmitt A, Volz A. Non-infectious granulomatous dermatoses. J Dtsch Dermatol Ges. 2019;17:518-533.
2. Aoun J, Habib R, Charaffeddine K, Taraif S, Loya A, Khalifeh I. Caseating granulomas in cutaneous leishmaniasis. PLoS Negl Trop Dis. 2014;8:e3255.
3. Culha G, Uzun S, Ozcan K, Memisoglu HR, Chang KP. Comparison of conventional and polymerase chain reaction diagnostic techniques for leishmaniasis in the endemic region of Adana, Turkey. Int J Dermatol. 2006;45:569-572.
4. Merdekios B, Pareyn M. Evaluation of conventional and four real-time PCR methods for the detection of Leishmania on field-collected samples in Ethiopia. PLoS Negl Trop Dis. 2021;15:e0008903.
5. Mashayekhi V, Mahmoudi M, Rastin M, Tayebi N, Taheri Ar, Tavakoli M. Detection of Leishmania DNA in paraffin embedded specimens of chronic lupoid leishmaniasis using polymerase chain reaction. Iran J Dermatol. 2012;15:69-73.
6. Wijesinghe H, Gunathilaka N, Semege S, et al. Histopathology of cutaneous leishmaniasis caused by Leishmania donovani in Sri Lanka. BioMed Res Int. 2020; 2020:4926819.
7. Razavi MR, Shirzadi MR, Mohebali M, et al. Human cutaneous leishmaniosis in Iran, up to date-2019. J Arthropod Borne Dis. 2021;15:143.
8. Holakouie-Naieni K, Mostafavi E, Boloorani AD, Mohebali M, Pakzad R. Spatial modeling of cutaneous leishmaniasis in Iran from 1983 to 2013. Acta Trop. 2017;166:67-73.
9. Weigle KA, Labrada LA, Lozano C, Santrich C, Barker DC. PCR-based diagnosis of acute and chronic cutaneous leishmaniasis caused by Leishmania (viannia). J Clin Microbiol. 2002;40:601-606.
10. Laskay T, Mikó TL, Negesse Y, Solbach W, Röllinghoff M, Frommel D. Detection of cutaneous Leishmania infection in paraffin-embedded skin biopsies using the polymerase chain reaction. Trans R Soc Trop Med Hyg. 1995;89:273-275.
11. Tomasini C, Moneghini L, Barbui AM. Chronic amastigote‐negative cutaneous leishmaniasis: A clinical, histopathologic and molecular study of 27 cases with emphasis on atypical and pseudolymphomatous presentations. J Cutan Pathol. 2017;44:530-537.
12. Böer A, Blödorn‐Schlicht N, Wiebels D, Steinkraus V, Falk T. Unusual histopathological features of cutaneous leishmaniasis identified by polymerase chain reaction specific for Leishmania on paraffin‐embedded skin biopsies. Br J Dermatol. 2006;155:815-819.
13. Namazi MJ, Dehkordi AB, Haghighi F, Mohammadzadeh M, Zarean M, Hasanabad MH. Molecular detection of Leishmania species in northeast of Iran. Comp Clin Path. 2018;27:729-733.
14. Arjmand R, Saberi S, Tolouei S, et al. Identification of Leishmania isolates from Varzaneh city, Isfahan province, Iran using nested polymerase chain reaction method. Adv Biomed Res. 2014;3.
15. Haddad MHF, Ghasemi E, Maraghi S, Tavala M. Identification of Leishmania species isolated from human cutaneous leishmaniasis in Mehran, Western Iran using nested PCR. Iran J Parasitol. 2016;11:65.
16. Mesgarian F, Rahbarian N, Mahmoudi Rad M, et al. Identification of Leishmania species isolated from human cutaneous leishmaniasis in Gonbad-e-Qabus city using a PCR method during 2006-2007. Tehran Univ Med J. 2010;68(4):250-256.
17. Mohammadi R, Mirhendi H, Yadegari MH, Shadzi S, Jalalizand N. Identification and frequency of candida species in patients with different forms of candidiasis in Isfahan, using PCR-RFLP method. Journal of Isfahan Medical School. 2011;29(133).
18. Rostami MN, Saghafipour A, Vesali E. A newly emerged cutaneous leishmaniasis focus in central Iran. Int J Infect Dis. 2013;17:e1198-e1206.
19. Farahmand M, Nahrevanian H, Shirazi HA, Naeimi S, Farzanehnejad Z. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran. Braz J Infect Dis. 2011;15:17-21.
20. Izadi S, Mirhendi H, Jalalizand N, et al. Molecular epidemiological survey of cutaneous leishmaniasis in two highly endemic metropolises of Iran, application of FTA cards for DNA extraction from giemsa-stained slides. Jundishapur J Microbiol. 2016;9(2).
21. Maraghi S, Mardanshah O, Rafiei A, Samarbafzadeh A, Vazirianzadeh B. Identification of cutaneous leishmaniasis agents in four geographical regions of Khuzestan province using nested PCR. Jundishapur J Microbiol. 2013;6(4):e4866.
22. Shiee MR, Mohebali M, Doroodgar A, Teimouri A, Afzali H, Shirzadi MR. A molecular and parasitological survey on cutaneous leishmaniasis patients from historical city of Kashan in Isfahan province, center of Iran. Asian Pacific Journal of Tropical Disease. 2012;2:421-425.
23. Mimori T, Sasaki J-i, Nakata M, et al. Rapid identification of Leishmania species from formalin-fixed biopsy samples by polymorphism-specific polymerase chain reaction. Gene. 1998;210:179-186.
24. Belli A, Rodriguez B, Aviles H, Harris E. Simplified polymerase chain reaction detection of new world Leishmania in clinical specimens of cutaneous leishmaniasis. Am J Trop Med Hyg. 1998;58:102-109.
25. Ramírez JR, Agudelo S, Muskus C, Alzate JF, Berberich C, Barker D, Velez ID. Diagnosis of cutaneous leishmaniasis in Colombia: The sampling site within lesions influences the sensitivity of parasitologic diagnosis. J Clin Microbiol. 2000;38:3768-3773.
26. Aviles H, Belli A, Armijos R, Monroy FP, Harris E. PCR detection and identification of Leishmania parasites in clinical specimens in Ecuador: A comparison with classical diagnostic methods. J Parasitol. 1999:181-187.
27. Pirmez C, da Silva Trajano V, et al. Use of PCR in diagnosis of human American tegumentary leishmaniasis in Rio de Janeiro, Brazil. J Clin Microbiol. 1999;37:1819-1823.
28. Karami M, Doudi M, Setorki M. Assessing epidemiology of cutaneous leishmaniasis in Isfahan, Iran. J Vector Borne Dis. 2013;50:30.
29. Kassiri H, Lotfi M, Farajifard P, Kassiri E. Laboratory diagnosis, clinical manifestations, epidemiological situation and public health importance of cutaneous leishmaniasis in Shushtar County, Southwestern Iran. Journal of Acute Disease. 2014;3(2):93-98.
30. Azizi K, Badzohreh A, Sarkari B, et al. Nested polymerase chain reaction and sequence-based detection of Leishmania infection of sand flies in recently emerged endemic focus of zoonotic cutaneous leishmaniasis, Southern Iran. Iran J Med Sci. 2013;38:156.
31. Khosravi A, Sharifi I, Dortaj E, Afshar AA, Mostafavi M. The present status of cutaneous leishmaniasis in a recently emerged focus in South-west of Kerman Province, Iran. Iran J Public Health. 2013;42:182.
32. Doroodgar A, Sayyah M, Doroodgar M, Mahbobi S, Nemetian M, Rafizadeh S, Rassi Y. Progressive increasing of cutaneous leishmaniasis in Kashan district, central of Iran. Asian Pacific J Trop Dis. 2012;2:260-263.
33. Hamzavi Y, Khademi N. Trend of cutaneous leishmaniasis in Kermanshah province, west of Iran from 1990 to 2012. Iran J Parasitol. 2015;10:78.
34. Abdolmajid F, Ghodratollah SS, Hushang R, Mojtaba MB, Ali MM, Abdolghayoum M. Identification of Leishmania species by kinetoplast DNA-polymerase chain reaction for the first time in Khaf district, Khorasan-e-Razavi province, Iran. Trop Parasitol. 2015;5:50.
2. Aoun J, Habib R, Charaffeddine K, Taraif S, Loya A, Khalifeh I. Caseating granulomas in cutaneous leishmaniasis. PLoS Negl Trop Dis. 2014;8:e3255.
3. Culha G, Uzun S, Ozcan K, Memisoglu HR, Chang KP. Comparison of conventional and polymerase chain reaction diagnostic techniques for leishmaniasis in the endemic region of Adana, Turkey. Int J Dermatol. 2006;45:569-572.
4. Merdekios B, Pareyn M. Evaluation of conventional and four real-time PCR methods for the detection of Leishmania on field-collected samples in Ethiopia. PLoS Negl Trop Dis. 2021;15:e0008903.
5. Mashayekhi V, Mahmoudi M, Rastin M, Tayebi N, Taheri Ar, Tavakoli M. Detection of Leishmania DNA in paraffin embedded specimens of chronic lupoid leishmaniasis using polymerase chain reaction. Iran J Dermatol. 2012;15:69-73.
6. Wijesinghe H, Gunathilaka N, Semege S, et al. Histopathology of cutaneous leishmaniasis caused by Leishmania donovani in Sri Lanka. BioMed Res Int. 2020; 2020:4926819.
7. Razavi MR, Shirzadi MR, Mohebali M, et al. Human cutaneous leishmaniosis in Iran, up to date-2019. J Arthropod Borne Dis. 2021;15:143.
8. Holakouie-Naieni K, Mostafavi E, Boloorani AD, Mohebali M, Pakzad R. Spatial modeling of cutaneous leishmaniasis in Iran from 1983 to 2013. Acta Trop. 2017;166:67-73.
9. Weigle KA, Labrada LA, Lozano C, Santrich C, Barker DC. PCR-based diagnosis of acute and chronic cutaneous leishmaniasis caused by Leishmania (viannia). J Clin Microbiol. 2002;40:601-606.
10. Laskay T, Mikó TL, Negesse Y, Solbach W, Röllinghoff M, Frommel D. Detection of cutaneous Leishmania infection in paraffin-embedded skin biopsies using the polymerase chain reaction. Trans R Soc Trop Med Hyg. 1995;89:273-275.
11. Tomasini C, Moneghini L, Barbui AM. Chronic amastigote‐negative cutaneous leishmaniasis: A clinical, histopathologic and molecular study of 27 cases with emphasis on atypical and pseudolymphomatous presentations. J Cutan Pathol. 2017;44:530-537.
12. Böer A, Blödorn‐Schlicht N, Wiebels D, Steinkraus V, Falk T. Unusual histopathological features of cutaneous leishmaniasis identified by polymerase chain reaction specific for Leishmania on paraffin‐embedded skin biopsies. Br J Dermatol. 2006;155:815-819.
13. Namazi MJ, Dehkordi AB, Haghighi F, Mohammadzadeh M, Zarean M, Hasanabad MH. Molecular detection of Leishmania species in northeast of Iran. Comp Clin Path. 2018;27:729-733.
14. Arjmand R, Saberi S, Tolouei S, et al. Identification of Leishmania isolates from Varzaneh city, Isfahan province, Iran using nested polymerase chain reaction method. Adv Biomed Res. 2014;3.
15. Haddad MHF, Ghasemi E, Maraghi S, Tavala M. Identification of Leishmania species isolated from human cutaneous leishmaniasis in Mehran, Western Iran using nested PCR. Iran J Parasitol. 2016;11:65.
16. Mesgarian F, Rahbarian N, Mahmoudi Rad M, et al. Identification of Leishmania species isolated from human cutaneous leishmaniasis in Gonbad-e-Qabus city using a PCR method during 2006-2007. Tehran Univ Med J. 2010;68(4):250-256.
17. Mohammadi R, Mirhendi H, Yadegari MH, Shadzi S, Jalalizand N. Identification and frequency of candida species in patients with different forms of candidiasis in Isfahan, using PCR-RFLP method. Journal of Isfahan Medical School. 2011;29(133).
18. Rostami MN, Saghafipour A, Vesali E. A newly emerged cutaneous leishmaniasis focus in central Iran. Int J Infect Dis. 2013;17:e1198-e1206.
19. Farahmand M, Nahrevanian H, Shirazi HA, Naeimi S, Farzanehnejad Z. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran. Braz J Infect Dis. 2011;15:17-21.
20. Izadi S, Mirhendi H, Jalalizand N, et al. Molecular epidemiological survey of cutaneous leishmaniasis in two highly endemic metropolises of Iran, application of FTA cards for DNA extraction from giemsa-stained slides. Jundishapur J Microbiol. 2016;9(2).
21. Maraghi S, Mardanshah O, Rafiei A, Samarbafzadeh A, Vazirianzadeh B. Identification of cutaneous leishmaniasis agents in four geographical regions of Khuzestan province using nested PCR. Jundishapur J Microbiol. 2013;6(4):e4866.
22. Shiee MR, Mohebali M, Doroodgar A, Teimouri A, Afzali H, Shirzadi MR. A molecular and parasitological survey on cutaneous leishmaniasis patients from historical city of Kashan in Isfahan province, center of Iran. Asian Pacific Journal of Tropical Disease. 2012;2:421-425.
23. Mimori T, Sasaki J-i, Nakata M, et al. Rapid identification of Leishmania species from formalin-fixed biopsy samples by polymorphism-specific polymerase chain reaction. Gene. 1998;210:179-186.
24. Belli A, Rodriguez B, Aviles H, Harris E. Simplified polymerase chain reaction detection of new world Leishmania in clinical specimens of cutaneous leishmaniasis. Am J Trop Med Hyg. 1998;58:102-109.
25. Ramírez JR, Agudelo S, Muskus C, Alzate JF, Berberich C, Barker D, Velez ID. Diagnosis of cutaneous leishmaniasis in Colombia: The sampling site within lesions influences the sensitivity of parasitologic diagnosis. J Clin Microbiol. 2000;38:3768-3773.
26. Aviles H, Belli A, Armijos R, Monroy FP, Harris E. PCR detection and identification of Leishmania parasites in clinical specimens in Ecuador: A comparison with classical diagnostic methods. J Parasitol. 1999:181-187.
27. Pirmez C, da Silva Trajano V, et al. Use of PCR in diagnosis of human American tegumentary leishmaniasis in Rio de Janeiro, Brazil. J Clin Microbiol. 1999;37:1819-1823.
28. Karami M, Doudi M, Setorki M. Assessing epidemiology of cutaneous leishmaniasis in Isfahan, Iran. J Vector Borne Dis. 2013;50:30.
29. Kassiri H, Lotfi M, Farajifard P, Kassiri E. Laboratory diagnosis, clinical manifestations, epidemiological situation and public health importance of cutaneous leishmaniasis in Shushtar County, Southwestern Iran. Journal of Acute Disease. 2014;3(2):93-98.
30. Azizi K, Badzohreh A, Sarkari B, et al. Nested polymerase chain reaction and sequence-based detection of Leishmania infection of sand flies in recently emerged endemic focus of zoonotic cutaneous leishmaniasis, Southern Iran. Iran J Med Sci. 2013;38:156.
31. Khosravi A, Sharifi I, Dortaj E, Afshar AA, Mostafavi M. The present status of cutaneous leishmaniasis in a recently emerged focus in South-west of Kerman Province, Iran. Iran J Public Health. 2013;42:182.
32. Doroodgar A, Sayyah M, Doroodgar M, Mahbobi S, Nemetian M, Rafizadeh S, Rassi Y. Progressive increasing of cutaneous leishmaniasis in Kashan district, central of Iran. Asian Pacific J Trop Dis. 2012;2:260-263.
33. Hamzavi Y, Khademi N. Trend of cutaneous leishmaniasis in Kermanshah province, west of Iran from 1990 to 2012. Iran J Parasitol. 2015;10:78.
34. Abdolmajid F, Ghodratollah SS, Hushang R, Mojtaba MB, Ali MM, Abdolghayoum M. Identification of Leishmania species by kinetoplast DNA-polymerase chain reaction for the first time in Khaf district, Khorasan-e-Razavi province, Iran. Trop Parasitol. 2015;5:50.
| Files | ||
| Issue | Vol 17 No 4 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v17i4.11285 | |
| Keywords | ||
| Leishmania Granuloma Polymerase chain reaction Iran | ||
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How to Cite
1.
Nahidi Y, Tayyebi Meibodi N, Ghazvini K, Arabi Moghadam H sadat, Akhlaghi S, Torabian F. PCR-Based Diagnosis of Leishmania Species in Chronic Granulomatous Dermatitis in Mashhad, Iran. Iran J Parasitol. 2022;17(4):573-582.
