Diagnostic Value of Histological Analysis of Punch Biopsies in Suspected Cutaneous Buruli Ulcer: A Study on 32 Cases of Confirmed Buruli Ulcer in Cameroon

Overview

Journal Dermatopathology (Basel)

Publisher MDPI

Specialty Pathology

Date 2019 Jun 14

PMID 31192197

Citations 2

Authors

Yasmine Lucile Ibrahim

Isabelle Masouye

Elizabeth Tschanz

Paul Atangana

Jean-Francois Etard

Micaela Serafini

Yolanda K Mueller

Laurence Toutous Trellu

Affiliations

Soon will be listed here.

Abstract

Background: Buruli ulcer (BU) is a cutaneous infectious disease caused by . In this prospective study, we aim to clarify the main histopathological features of cutaneous BU based on 4-mm skin punch biopsies and to evaluate the diagnostic value of this method.

Methods: Between 2011 and 2013, a prospective study was conducted in Cameroon. Dry swabs from ulcerative lesions and fine-needle aspirates of nonulcerative lesions were examined for Ziehl-Neelsen (ZN) staining, followed by PCR targeting IS2404 and culture. Two 4-mm punch biopsies were performed in the center and in the periphery of each lesion.

Results: The 364 patients included in the study had 422 lesions (381 were ulcerative and 357 lesions were biopsied). Among the 99 ulcerated lesions with a final diagnosis of BU, histological features for BU were fulfilled in 32 lesions. 32/32 showed subcutaneous necrosis with a neutrophilic inflammatory infiltrate. 26/32 presented alcohol-resistant bacilli confirmed by ZN stain on histology.

Conclusion: Punch biopsies help in establishing the correct diagnosis of BU and also in the differential diagnosis of chronic ulcers. The main histological feature for BU is diffuse coagulative necrosis of subcutaneous tissue, with acid-fast bacilli detected by ZN stain.

Citing Articles

Recent Advances in the Management Strategies for Buruli Ulcers.

Popa G, Muntean A, Popa M Pathogens. 2023; 12(9).

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A Systematic Review on Suitability of Molecular Techniques for Diagnosis and Research into Infectious Diseases of Concern in Resource-Limited Settings.

Yalley A, Ahiatrogah S, Kafintu-Kwashie A, Amegatcher G, Prah D, Botwe A Curr Issues Mol Biol. 2022; 44(10):4367-4385.

PMID: 36286015 PMC: 9601131. DOI: 10.3390/cimb44100300.

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