Skip to main content

Advertisement

SpringerLink
Log in

Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations

  • Case Report
  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

A single-center retrospective study reviewed the following sonographic features of 18 confirmed cases of localized cutaneous leishmaniasis to identify shared presentation patterns: echotexture, lesion borders, hypodermal involvement, soft-tissue changes, and vascular pattern. A second objective was to correlate these patterns with clinical characteristics, including sex, age, anatomical location, nodule vs. plaque presentation, raised borders, granulation tissue, swelling, hyperkeratotic crusting, disease onset, and healing time. Two main patterns were identified with high-frequency ultrasonography. The first pattern was characterized by a high level of inflammation and deep hypodermal involvement, while the second variant showed involvement limited to the dermis, with minimal inflammation. The "inflammatory pattern" showed ill-defined borders, mixed echotexture, prominent vascularity with central distribution, and was correlated with clinical signs of ulceration, granulation tissue, raised borders, and longer healing time (p < 0.05). The "pauci-inflammatory pattern" presented a well-defined structure with decreased echogenicity, reduced or absent vascularity with minimal soft-tissue changes, and was associated with a shorter healing time (p < 0.05).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hepburn NC (2000) Cutaneous leishmaniasis. Clin Exp Dermatol 25:363–370

    Article  CAS  Google Scholar 

  2. Scott P, Novais FO (2016) Cutaneous leishmaniasis: immune responses in protection and pathogenesis. Nat Rev Immunol 16(9):581–592

    Article  CAS  Google Scholar 

  3. Sharquie KE, Hameed AF, Noaimi AA (2016) Panniculitis is a common unrecognized histopathological feature of cutaneous leishmaniasis. Indian J Pathol Microbiol 59(1):16–19

    PubMed  Google Scholar 

  4. Thilakarathne IK, Ratnayake P, Vithanage A, Sugathadasa DP (2019) Role of histopathology in the diagnosis of cutaneous leishmaniasis: a case-control study in Sri Lanka. Am J Dermatopathol 41(8):566–570

    Article  Google Scholar 

  5. Merino-Espinosa G, Corpas-López V, Díaz-Sáez V et al (2018) Cutaneous leishmaniasis by Leishmania infantum: behind granulomatous lesions of unknown aetiology. J Eur Acad Dermatol Venereol 32(1):117–124

    Article  CAS  Google Scholar 

  6. Saavedra AC, Valencia BM, Tueros P, Wortsman X, Llanos-Cuentas A, Lavarello RJ (2019) Ultrasonographic characteristics of cutaneous leishmaniasis. J Eur Acad Dermatol Venereol 34(4):e193–e195

    Google Scholar 

  7. Rojas Mora E, Garrido Ríos A, Echeverría García B, Borbujo J (2019) An unusual presentation of cutaneous leishmaniasis: the role of skin ultrasound. Actas Dermosifiliogr 110(2):171–174

    Article  CAS  Google Scholar 

  8. Novais FO, Nguyen BT, Beiting DP et al (2014) Human classical monocytes control the intracellular stage of Leishmania braziliensis by reactive oxygen species. J Infect Dis 209(8):1288–1296

    Article  CAS  Google Scholar 

  9. Romero-Maté A, Martínez-Sánchez D, Tardío JC et al (2012) Cutaneous leishmaniasis with histopathologic pattern of non-necrotizing granulomatous dermatitis in patients treated with adalimumab. Dermatol Online J 18(9):7

    Article  Google Scholar 

  10. Faria DR, Souza PEA, Durães FV et al (2009) Recruitment of CD8+ T cells expressing granzyme A is associated with lesion progression in human cutaneous leishmaniasis. Parasite Immunol 31(8):432–439

    Article  CAS  Google Scholar 

  11. Sadick MD, Heinzel FP, Holaday BJ, Pu RT, Dawkins RS, Locksley RM (1990). Cure of murine leishmaniasis with anti-interleukin 4 monoclonal antibody. Evidence for a T cell-dependent, interferon gamma-independent mechanism. J Exp Med 171(1):115–27.

  12. Catalano O, Varelli C, Sbordone C et al (2020) A bump: what to do next? Ultrasound imaging of superficial soft-tissue palpable lesions. J Ultrasound 23:287–300

    Article  Google Scholar 

  13. Esposito S, Ferrara D, Di Serafino M et al (2019) Classification and ultrasound findings of vascular anomalies in pediatric age: the essential. J Ultrasound 22(1):13–25

    Article  Google Scholar 

  14. Knöpfel N, Gómez-Zubiaur A, Noguera-Morel L, Torrelo A, Hernandez-Martin A (2018) Ultrasound findings in idiopathic facial aseptic granuloma: case series and literature review. Pediatr Dermatol 35(3):397–400

    Article  Google Scholar 

  15. Pousa-Martínez M, Sánchez-Aguilar D, Aliste C, Vázquez-Veiga H (2017) Usefulness of ultrasound in the diagnosis and follow-up of pyoderma gangrenosum. Actas Dermosifiliogr 108(10):962–964

    Article  Google Scholar 

  16. Corvino A, Sandomenico F, Corvino F, et al. Utility of a gel stand-off pad in the detection of Doppler signal on focal nodular lesions of the skin (2020). J Ultrasound. 23(1):45–53.

  17. Catalano O, Alfageme Roldán F, Varelli C et al (2019) Skin cancer: findings and role of high-resolution ultrasound. J Ultrasound 22(4):423–431

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant’ Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy

    Andrea Sechi, Iria Neri, Annalisa Patrizi, Ambra Di Altobrando, Miriam Leuzzi, Cosimo Misciali & Valeria Gaspari

  2. Radiology Unit, University Hospital of Bologna Sant’ Orsola-Malpighi Polyclinic, Bologna, Italy

    Roberta Clinca

  3. Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

    Raffaele Dante Caposiena Caro

Authors
  1. Andrea Sechi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Iria Neri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annalisa Patrizi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ambra Di Altobrando
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Roberta Clinca
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Raffaele Dante Caposiena Caro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Miriam Leuzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cosimo Misciali
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Valeria Gaspari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Sechi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sechi, A., Neri, I., Patrizi, A. et al. Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations. J Ultrasound 25, 343–348 (2022). https://doi.org/10.1007/s40477-020-00537-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40477-020-00537-9

Keywords

Search

Navigation