Immunohistochemistry and polymerase chain reaction on paraffin-embedded material improve the diagnosis of cutaneous leishmaniasis in the Amazon region

Background  Recently, there has been an increase in the incidence of cutaneous leishmaniasis (CL), which represents an important health problem. This increase may be related to the epidemiologic expansion of the infective agent and the increase in tourism in tropical areas. The difficulty in clinica...

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Published in:International journal of dermatology 2009-10, Vol.48 (10), p.1091-1095
Main Authors: Amato, Valdir Sabbaga, Tuon, Felipe Francisco, De Andrade, Jr, Heitor Franco, Bacha, Helio, Pagliari, Carla, Fernandes, Elaine Raniero, Duarte, Maria Irma Seixas, Neto, Vicente Amato, Zampieri, Ricardo Andrade, Floeter-Winter, Lucile Maria, Celeste, Beatriz J., Oliveira, Juliane, Quiroga, Mariana Martinez, Mascheretti, Melissa, Boulos, Marcos
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Brazil
Dermatology
Human protozoal diseases
Humans
Immunohistochemistry
Infectious diseases
Leishmania
Leishmaniasis, Cutaneous - diagnosis
Leshmaniasis
Medical sciences
Middle Aged
Paraffin Embedding
Parasitic diseases
Polymerase Chain Reaction
Prospective Studies
Protozoal diseases
Sensitivity and Specificity
Young Adult
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Summary:Background  Recently, there has been an increase in the incidence of cutaneous leishmaniasis (CL), which represents an important health problem. This increase may be related to the epidemiologic expansion of the infective agent and the increase in tourism in tropical areas. The difficulty in clinical diagnosis, mainly in areas in which CL is not the first consideration of local physicians, has intensified efforts to describe diagnostic tests, which should be specific, sensitive, and practical. Amongst the new tests described are those including nucleic acid amplification (polymerase chain reaction, PCR) and immunohistochemistry (IHC). Methods  In this study, we evaluated the sensitivity of a PCR based on small subunit (SSU) ribosomal DNA, in comparison with IHC using Leishmania spp. antibodies, in biopsies embedded in paraffin. Result  The results indicated a total sensitivity of 96% (90.9% with PCR and 68.8% with IHC), showing the possibility of using paraffin‐embedded biopsies to diagnose CL. Conclusion  We propose the use of the two tests together as a routine protocol for diagnosis. This would require the provision of local medical services to perform molecular biology techniques and adequate Leishmania antibodies.
ISSN:0011-9059
1365-4632
DOI:10.1111/j.1365-4632.2009.04099.x