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Peripheral nerve involvement in cutaneous leishmaniasis (Old World).
R Kubba1, A M el-Hassan, Y Al-Gindan
1National Leishmaniasis Research Project (SANCST), King Faisal University, Dammam, Saudi Arabia.
International Journal of Dermatology
|October 1, 1987
Summary
Cutaneous leishmaniasis caused by Leishmania major can affect nerves, with 5% of skin biopsies showing nerve changes like inflammation and destruction. Some patients also experienced diminished skin sensation due to these nerve alterations.
Area of Science:
- Dermatology
- Neurology
- Infectious Diseases
Background:
- Cutaneous leishmaniasis (CL) is a parasitic disease caused by Leishmania species.
- Leishmania major is a common causative agent of CL, particularly in certain regions.
- The pathological effects of CL on skin structures are well-documented, but nerve involvement requires further investigation.
Observation:
- A review of 288 skin biopsy specimens from CL lesions caused by Leishmania major was conducted.
- Nerve changes were identified in 14 specimens (5%).
- These changes included perineural inflammatory cell infiltrate, neuritis, nerve destruction, and intraneural amastigotes.
Findings:
- Perineural inflammation was observed in 10 patients.
- Neuritis with inflammatory cell invasion of nerves occurred in 4 patients, with one case showing granulomatous inflammation and nerve destruction.
- Amastigotes were found within nerves in 2 patients.
- Sensory testing revealed diminished sensation in 2 out of 50 CL patients.
Implications:
- Leishmania major infection can directly impact peripheral nerves, leading to significant histopathological changes.
- Nerve involvement in CL may contribute to sensory disturbances experienced by patients.
- Understanding these neuropathological aspects is crucial for comprehensive patient management and treatment strategies for cutaneous leishmaniasis.