Diffuse cutaneous leishmaniasis in Ethiopia I. The clinical and histological features of the disease

Publisher Website
Google Scholar
Abstract
The clinical and histological features of 33 cases of diffuse cutaneous leishmaniasis (DCL) seen in Ethiopia are described. The disease starts as a nodule, usually on a limb. After a period of months or years, during which the initial lesion may rarely ulcerate, or even disappear, it starts to spread locally and distant metastases appear on the face, arms and legs; in appearance and distribution they bear some resemblance to leprosy. The disease spreads slowly, does not ulcerate, invade the viscera or heal. The patient remains remarkably well and there are no consistently abnormal findings in the blood or urine. Smears from the lesions show numerous amastigotes (L-D bodies). The histology is characterized by a thin epidermis and an intense dermal infiltration with macrophages, many of them vacuolated and stuffed with parasites; lymphocytes are absent or scanty. Under the influence of treatment the histology changes towards the tuberculoid. The leishmanin skin test is negative.