Non-ulcerated or atypical cutaneous leishmaniasis caused by Leishmania infantum chagasi in Amapala municipality, Valle, Honduras: immune-histological characterization of the skin lesions

Abstract

In the Americas, particularly in South America, infection with Leishmania (Leishmania) infantum chagasi cause subclinical manifestations and visceral leishmaniasis (VL), which if untreated is potentially fatal. In Honduras, the leishmaniasis by L. (L.) infantum chagasi causes visceral leishmaniasis (VL), but has also been reported the non-ulcerated or atypical cutaneous leishmaniasis (NUCL) caused by this specie of parasite. There are cases of non-ulcerated or atypical cutaneous leishmaniasis (LCA), also reported in other countries in Central America, such as Costa Rica, El Salvador and Nicaragua. In Honduras, there are endemic areas well identified of this non-ulcerated clinical variant, located in Choluteca and Valle departments, as well as the southern part of Francisco Morazán department, La Paz, El Paraiso and Olancho. We intend to do an active search of patients with non-ulcerated or atypical cutaneous leishmaniasis in the city of Amapala, Valle department, Honduras, from January to December 2015. After clinical examination, biopsies of skin lesions of these patients, which are defined as a papule, plaque or asymptomatic infiltrative nodule, with no ulceration, erythematous or skin color, with or without the presence of hypo-pigmented halo, will be collected, fixed in formalin solution 10% buffered 0.01M and processed by the usual techniques of microscopy optical. Histological sections stained by HE will be used to characterize the histopathological changes of the cutaneous lesions and another histological sections will be processed by immunohistochemistry using primary antibodies to dendritic cells (CD1a, CD11c), macrophages (CD68), T lymphocytes (CD4, CD8 and FoxP3) and intracellular markers (IL-10, TGF-b, IFN-g and iNOS) in order to evaluate the in situ immunity. (AU)