Cutaneous leishmaniasis: Comparative Techniques for Diagnosis

Background: Cutaneous leishmaniasis is a major public health problem as a disease endemic in Iraqi population. Many diagnostic tools are used to establish the diagnosis like smear, histopathology and culture. Objectives: To find more rapid, sensitive and specific diagnostic method, to establish the diagnosis of cutaneous leishmaniasis. Patients and methods: Sixty patients with clinical diagnosis of cutaneous leishmaniasis were included in present work during the period between December / 2012 to May / 2013 in Department of Dermatology in Baghdad Teaching Hospital, Al-Yarmook Teaching Hospital and Al-Karama Teaching Hospital and Microbiology Department in collage of Medicine / University of Baghdad. The following diagnostic techniques were carried out for diagnosis of cutaneous leishmaniasis including dental broach smear, histopathology examination and culture on Roswell park medium institute (RPM I 1640) and on NNN media. In addition to PCR technique was performed for all patients. Sixty patients with other skin lesions were processed for PCR as a control group. Results: Sixty patients with cutaneous leishmaniasis, 39 males and 21 females with range age from 6 months to 55 years with a median 24 years. The results of diagnostic techniques were as follow: dental broach smear positive in 41 (68.33%), histopathology in 6(27.27%), culture in 45(75%) and the PCR positive in 55 (91.66%) patients. By PCR,the study differentiated Leishmania major (60%) and Leishmania tropica (40%). PCR was the most sensitive (91.66%) and specific (100%) technique when compared with other diagnostic techniques. Conclusion: In conclusion, PCR differentiated two species of Leishmania in Iraq, 60% Leishmania major and 40% Leishmania tropica and it was the most sensitive and specific diagnostic test in cutaneous leishmaniasis. I.