Quintella et al developed a model for differentiating American cutaneous leishmaniasis from sporotrichososis on a skin biopsy. The authors are from Rio de Janeiro in Brazil.
|
Features of Cutaneous Leishmaniasis |
Points if Present |
|
macrophage concentration |
1.65 |
|
extracellular matrix degeneration |
1.51 |
|
tuberculoid granuloma |
1.34 |
where:
• Macrophage concentration = loose, poorly formed and poorly delimited aggregates of epithelioid cells within a background of a lymphoplasmacytic infiltrate
|
Features of Sporotrichosis |
Points if Present |
|
suppurative granuloma |
-2.49 |
|
abscess outside of granuloma |
-1.89 |
|
granulomas in granulation tissue |
-1.71 |
|
stellate granuloma |
-1.54 |
|
more than one type of multinucleated giant cells |
-1.27 |
total score =
= SUM(points for all 8 findings)
Interpretation:
• minimum score: -8.9
• maximum score: 4.6
• A high score was seen with leismaniasis and a low score with sporotrichosis.
• The authors identified –1.2 as the cutoff between the 2 disorders.
From Figure 4 on page 842
|
Score |
Diagnosis |
|
< -3 |
sporotrichosis |
|
-3 to –1.2 |
probably sporotrichosis |
|
-1.2 to 0 |
indetermminate |
|
0 to 2 |
probably leishmaniasis |
|
> 2 |
leishmaniasis |
Specialty: Infectious Diseases
