In vivo Confocal Microscopy Features of Cutaneous Leishmaniasis

Abstract

Background: Cutaneous leishmaniasis is widely distributed, Spain being a hypoendemic region. Noninvasive bedside detection of the histopathologic response to the intracellular organism that allows rapid diagnosis and prompt therapy could be the ideal tool to manage a commonly self-healing lesion. Confocal microscopy is a technique which allows in vivo examination of the skin at cellular resolution. Methods: We describe the in vivo confocal microscopic features of cutaneous leishmaniasis, finding a correlation with dermoscopy and histopathology. Conclusions and Relevance: This case illustrates the capability of confocal microscopy to characterize the cutaneous infection by Leishmania organisms and to perform a noninvasive diagnosis.

Dermoscopy and reflectance confocal microscopy in cutaneous leishmaniasis on the face

“…To date, only one case of RCM of CL has been published . Our patient adds eggs in a bird's nest as a novel RCM feature to intradermal polymorphic infiltrates, curved to longitudinal vessels and multinucleated giant cells, as previously reported . In our experience, this specific feature is not found in other granulomatous skin lesions.…”

The value ofin vivoreflectance confocal microscopy in the diagnosis and monitoring of inflammatory and infectious skin diseases: a systematic review

“…Other imaged diseases were alopecia and autoimmune connective tissue diseases like lupus, and systemic and lichen sclerosis . Moreover, various infectious skin diseases were studied by RCM (Table ): parasitic (Demodex folliculitis, larva migrans, leishmaniasis, scabies and Pyemotes ventricosus ), bacterial (secondary syphilis and bacterial secondary infection), fungal (tinea and onychomycosis), viral (varicella, herpes, human papillomavirus, molluscum contagiosum) . Because of the extensive spectrum of imaged ISD, the skin disorders with RCM diagnoses and/or feature accuracy determinations will be discussed in detail.…”

Reflectance confocal microscopy for cutaneous infections and infestations

“…One case of cutaneous Leishmaniasis was also observed under RCM 24 : a dermal inflammatory infiltrate with multinucleated cells was visible.RCM could be also useful to study the anatomical details of some parasites that are visible to the naked eye, such as ticks and lice (Fig. 2).…”