Diagnostic Accuracy of Cd1a Immuno Histochemical Evaluation in Comparison with H & E and Giemsa for Cutaneous Leishmaniasis
DOI:
https://doi.org/10.61919/jhrr.v3i2.272Keywords:
Cutaneous leishmaniasis, CD1a immunohistochemical staining, Hematoxylin and Eosin, Giemsa, histopathological diagnosis, Leishmania amastigotesAbstract
Background: Cutaneous leishmaniasis remains a global health challenge, with diagnosis largely dependent on the visualization of Leishmania parasites in infected tissue. Traditional staining methods, such as Hematoxylin and Eosin (H&E) and Giemsa, have been the cornerstone of histopathological diagnosis, but they come with limitations in sensitivity and specificity.
Objective: This study aimed to evaluate the diagnostic accuracy of CD1a immunohistochemical staining in the detection of leishmania amastigotes in skin biopsies and compare its efficacy with H&E and Giemsa staining methods.
Methods: A total of 110 skin biopsy samples with a strong clinical suspicion of cutaneous leishmaniasis were examined using H&E, Giemsa, and CD1a immunohistochemical staining techniques. The sensitivity and specificity of these methods were analyzed and compared to ascertain the most effective diagnostic approach.
Results: The study identified leishmania amastigotes in 78% of the cases using H&E staining, while Giemsa staining resulted in amastigote detection in 82% of cases. Notably, CD1a immunohistochemical staining showed a remarkable sensitivity, identifying amastigotes in 95% of the samples. The increase in detection rate with CD1a staining was statistically significant when compared to H&E (p<0.05), with CD1a revealing amastigotes in an additional 23% of cases where H&E staining was negative. Giemsa staining was able to detect amastigotes in three cases that were not visible with H&E, suggesting its potential role as a complementary technique in certain diagnostic scenarios.
Conclusion: The study concludes that CD1a immunohistochemical staining significantly enhances the detection of leishmania amastigotes and should be considered as an adjunct to conventional staining methods in the histopathological diagnosis of cutaneous leishmaniasis. Future diagnostic protocols could benefit from the incorporation of CD1a staining to improve accuracy.
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