Clinical and histopathological features of zoonotic cutaneous leishmaniasis in Saudi Arabia

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Abstract
Zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania major is a growing public health problem and endemic in many parts of the Kingdom of Saudi Arabia. The vector is Phlebotomus papatasi and the animal reservoirs are mainly desert rodents. In this prospective study, the clinical and histopathological features of ZCL in 120 patients are described and classified. The majority of these patients (n = 84) were non-Saudi expatriate workers who suffered mostly from multiple and severely inflamed nodulo-ulcerative lesions on the exposed parts of the body. Saudi patients were mainly children (n = 21) with few(1-3) lesions on their limbs or sometimes unique erysipeloid facial lesions. Histopathological grouping of ZCL lesions showed four types of granulomatous reactions based on the predominant types of inflammatory cells, presence or absence of necrosis and ranking of parasitic index. A possible correlation between histopathologic evolution of ZCL lesions and the immune status of the host is discussed.

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