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Primary biliary cholangitis (PBC), formerly known as primary biliary cirrhosis, is a liver disease. This is a chronic autoimmune disease, which can worsen over time and recur periodically. If left untreated, biliary cirrhosis may lead to liver failure. Considering that PBC is a rare disease in all age groups, especially in children, the purpose of this report was to describe a girl with hepatitis A virus (HAV) who was then diagnosed with PBC. This child is the first case reported in Iran. The patient is a 7-year-old girl with a pale complexion and eyes with a yellowish cross who was referred to the doctor. Considering that this patient had hepatitis, a blood test was requested to check the level of cholesterol and liver enzymes. The absence of cholestatic liver enzymes was observed in tests. Then, an anti-mitochondrial (AMA) test was requested for the patient, the result of which was negative. Finally, with imaging and biopsy, the diagnosis of PBC was confirmed for the patient. After the definite diagnosis of the disease, the child was treated with ursodeoxycholic acid (UDCA). The child in question is suffering from two medical and immunological diseases, HAV and PBC. Since this child was first infected with HAV, it is possible that the cause of PBC was HAV. [ABSTRACT FROM AUTHOR]

Background: People with premature hair graying try to hide it because it makes them look older than their age. Hair graying is an esthetic problem that affects social life. This preliminary study aimed to investigate the influencing factors in premature hair graying. Methods: One hundred twenty participants who were referred to a dermatology clinic were randomly selected and filled up an interview questionnaire. The questionnaire included demographic information such as age, sex, marital status, BMI, education level, and income. Also, queries on family history, cigarette smoking, and alcohol consumption were asked. The main question was the age of graying hair initiation which divided the participants into two groups; individuals with premature hair graying (PHG) under 30 and non-PHG individuals above 30 years old. Factors were compared and a logistic regression was used to identify the association. Results: The mean age of participants was 42.2±1.2 and 49% of them were female. Cigarette smoking, alcohol consumption, educational level, marital status, and family history were significantly different between the two subgroups. But the marital status, family history, and alcohol consumption were significantly associated with premature hair graying. Conclusion: Premature hair graying depends on family history and non-married people and alcohol users are more prone to it. More investigations are needed to identify the indicators. [ABSTRACT FROM AUTHOR]

BACKGROUND Functional dyspepsia is a common, troubling, and usually chronic disorder. Although the merit of using pathological assays has not been confirmed, medications affecting eosinophils may result in some improvements. Disseminated distribution of mast cells may also be an essential factor. Given the probable associations and lack of evidenced-based data, this study was conducted to comparatively investigate the number of eosinophils and mast cells in the duodenum in functional dyspepsia patients and healthy controls. METHODS In this case-control study, 150 consecutive subjects in Kerman, Iran, were enrolled in 2015 and 2016; the subjects consisted of 100 patients with functional dyspepsia and 50 asymptomatic healthy controls. Samples from the two groups were compared for the number of eosinophils, mast cells, and Helicobacter pylori presence by grasp biopsy. RESULTS The mean number of mast cells significantly differed between the groups (P = 0.001), but the eosinophil count was similar (p > 0.05). Female gender, no opioid use, and H. pylori may increase mast cell count (p < 0.05). CONCLUSION Overall, the mast cell count was significantly different between people with functional dyspepsia and people without it, but the eosinophil count in the two groups was similar. [ABSTRACT FROM AUTHOR]

Background: Bladder cancer is the second most common cancer of the genitourinary system and the eighth cause of cancer death. In addition to known risk factors such as smoking and urinary stones, trace elements are also effective in causing bladder cancer and other cancers. Objectives: This study was conducted to determine the association between bladder cancer and the carcinogens cadmium and arsenic. Methods: This case-control study was conducted on 40 patients with bladder cancer admitted to Shahid Bahonar Hospital and a control group of 40 healthy individuals in Kerman, Iran, in 2018. The serum levels of arsenic and cadmium were measured by atomic absorptiometry. The paired t-test and chi-square tests were employed to assess the difference between cases and controls groups. An unadjusted and 2 multivariable conditional regression models were separately adjusted on sex, family cancer history, residence, occupation, and smoking and were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) to assess the association between arsenic and cadmium levels and bladder cancer. The statistical software SPSS version 26 and R software version 3.6.3 were used to perform the statistical analyses. Results: The mean cadmium level was 2.99 ± 1.45 and 2.59 ± 0.46 in the case and control groups, respectively, with no statistically significant difference between the groups (P= 0.100). The mean arsenic level was 2.12 ± 1.04 and 1.43 ± 0.73 in the case and control groups, respectively, demonstrating a statistically significant difference between the groups (P = 0.001). Unadjusted and adjusted conditional logistic regression models indicated significant association between arsenic levels and bladder cancer (unadjusted: odds ratio (OR) (95% CI): 0.66 (0.46 - 0.94), P-value = 0.022; adjusted: OR(95% CI): 0.64 (0.44 - 0.92), P-value = 0.018). Conclusions: Overall, cadmium and arsenic levels are higher in patients with bladder cancer, with a statistically significant difference for arsenic. However, these elements are not interrelated and are not related to other factors. [ABSTRACT FROM AUTHOR]

Background and Objectives The association of JAK2 V617F mutation with myeloproliferative neoplasms was first reported in 2005. The present study was conducted to evaluate the frequency of JAK2 gene mutation in patients with myeloproliferative neoplasms in Kerman, Iran, from the years 2013 to 2018. Materials and Methods This descriptive cross-sectional study was performed among 276 patients with primary diagnosis of myeloproliferative neoplasms with subgroups PV, ET, PMF, and ABL-BCR negative referring to bone marrow laboratory of Bahonar Hospital during six years. Demographic, histopathologic, clinical, and JAK2 mutation data were collected. Data were analyzed by K2 test, Mann-Whitney U test and Kolmogorov-Smirnov test. Results Out of the total number of participants, 176 (64.9%) were male and 100 (35.1%) female with 101 (36.6%) patients having primary thrombocythemia, 81 (29.3%) primary myelofibrosis, 72 (26.1%) polycythemia vera, and 22 (8%) without diagnosis. Of all patients, JAK2 mutation was positive in 184 patients (66.6%). But the results showed that the frequency of positive mutations was 54.4% in primary thrombocytic patients, 59.2% in primary myelofibrosis patients, and 88.7% in polycythemia patients. This difference was statistically significant. ( p = 0.016) Conclusions Considering the comparability of JAK2 V617F mutation rate in Iranian patients with myeloproliferative neoplasms and previous reports, in order to standardize the diagnosis and control of treatment and prognosis, it seems neccessary to evaluate this mutation along with other histopathologic evaluations. [ABSTRACT FROM AUTHOR]

Background and Objectives Analyzing the knowledge of health personnel regarding blood transfusion can lead to the identification of shortcomings and defects in knowledge and provide guidance to medical personnel and blood transfusion centers to reform the existing conditions and revise the related educational programs. Therefore, in this study, the knowledge of different medical groups pertaining to haemovigilance was assessed in university (teaching) hospitals of Kerman. Materials and Methods In this cross-sectional study, 135 health personnel of three university hospitals in Kerman were selected using the convenience sampling method and included in this cross-sectional study in 2018. Each person was given a multiple choice questionnaire assessing the minimum knowledge required for transfusion, storage, and understanding possible side effects of blood products, and the level of awareness of each group regarding these issues was evaluated. Chisquare and t-tests were used for data analysis using SPSS21 software. Results The mean knowledge score of all participants was 16.30 ± 3.16 (out of 24 score), which showed an average level of knowledge among the participants. The highest level of knowledge was observed among nurses, followed by residents, and the interns' knowledge was lower than that of the other two groups; these differences were statistically significant (p = 0.001). Conclusions Based on the findings, the level of knowledge of medical personnel regarding blood transfusion is suboptimal, and continuous theoretical and practical training courses are recommended for different target groups. [ABSTRACT FROM AUTHOR]

Background:In tumoral cells, the HER-2/Neu is an oncogene and overexpression would result in further membranous proteins. The role of this gene is known in ling and breast cancers. This study was undertaken to determine the HER-2/Neu overexpression in gastrectomy samples in patients with gastric cancer and its association with tumor histopathology prognostic factors. Methods: This cross-sectional study was conducted among 48 samples of gastric cancer under gastrectomy. The slides were prepared to assess HER-2/Neu stained by IHC method (Biogenax Kit and DAOK criteria). Statistical analysis was done using SPSS software version 20.0. Results: Out of 48 cases, 79.2% were males. The mean age was 59.93 ± 13.95 years and the mean tumor size was 5.5 ± 2.45 cm. Majority of cases were in anthrum and pylor (43.8%). Lauren class showed a higher frequency of intestinal type (72.9%). In surgery the majority of cases were found to be in T3 stage (87.5%). Her-2/Neu was positive in 10.4% of cases and it was negative in 89.6% of cases. Despite the higher rate of tumors with further expression of HER-2/Neu in those with a size over 5 cm and with vascular invasion, there was no significant association between Her-2/Neu and other variables (P > 0.05). Conclusion: According to the results of this study, overexpression of HER-2/Neu in gastric cancer is low (10.4%) and there is no significant association with other variables. It is suggested that further similar studies with a larger sample size be carried out to definitely determine the association between this marker and prognostic factors. [ABSTRACT FROM AUTHOR]

ABSTRACT Stem cell research is very promising. The use of human embryos has been confronted with objections based on ethical and religious positions. The recent production of reprogrammed adult (induced pluripotent) cells does not - in the opinion of scientists - reduce the need to continue human embryonic stem cell research. So the debate continues. Islam always encouraged scientific research, particularly research directed toward finding cures for human disease. Based on the expectation of potential benefits, Islamic teachings permit and support human embryonic stem cell research. The majority of Muslim scholars also support therapeutic cloning. This permissibility is conditional on the use of supernumerary early pre-embryos which are obtained during infertility treatment in vitro fertilization (IVF) clinics. The early pre-embryos are considered in Islamic jurisprudence as worthy of respect but do not have the full sanctity offered to the embryo after implantation in the uterus and especially after ensoulment. In this paper the Islamic positions regarding human embryonic stem cell research and therapeutic cloning are reviewed in some detail, whereas positions in other religious traditions are mentioned only briefly. The status of human embryonic stem cell research and therapeutic cloning in different countries, including the USA and especially in Muslim countries, is discussed. [ABSTRACT FROM AUTHOR]

Purpose: Cancer survivors may experience a subsequent primary cancer that affects their survival and quality of life. This study aimed to investigate the epidemiology of multiple primary malignant neoplasms (MPMNs) in Kerman province, southeast Iran during 2014-2020., Materials and Methods: In this retrospective cohort study, all patients who had been diagnosed with primary cancers and registered with the Kerman Cancer Registry Program (KPBCR) during 2014-2020 were included. MPMNs were defined as primary malignant tumors arising in different sites and/or were of different histological or morphological origins. If the second malignancy was diagnosed within the first six months from the diagnosis of the first tumor it was considered synchronous, and if after six months it was defined as metachronous. Logistic regression was used to analyze the relationship between age, sex, and primary cancer site with incidence and survival of secondary in the entire population., Results: Of 26,315 patients registered with a primary cancer diagnosis, 492 (1.86%) developed subsequent primary cancers. The most common type of secondary cancer was skin and mucosa (n=131, 26.63%) followed by urogenital (n=115, 23.37%), followed by, gastrointestinal (n=62, 14.45%), and breast neoplasms (n=57, 11.59%). Most patients had metachronous tumors (n=350, 71.13%). The primary cancer site (Skin and mucosa, urogenital, and breast) was significantly associated with developing subsequent cancer among cancer survivors. The overall 5-year survival of MPMNs cases was over 50%. Older age at diagnosis (HR= 1.02) and having synchronous tumors (HR=1.41) were negatively associated with the survival time of patients with MPMNs., Conclusion: Both patients and physicians should be taught about the importance of prevention and the provision of care and screening services among cancer survivors. Studying the epidemiology, susceptibility, and risk factors of MPMNs among cancer survivors will open windows to a better understanding of this phenomenon and policy making.

Background: Laboratory services play an important role in optimizing patient care today, and the importance of clinical laboratories is now widely accepted in medical practice. A critical value, originally described by Lundberg more than 30 years ago, refers to an abnormal test result that can lead to a serious life threat if not reported in a timely manner. In this study, we tried to determine the importance of critical values that can lead to a serious life threat with regard to their prevalence and frequency in laboratory tests of Iranian patients. Methods: In this cross-sectional study, the frequency of critical values in laboratory tests were determined and compared according to the type of laboratory parameter, age, sex, the inpatient/outpatient status, the related clinical ward, recurrence of critical values in the patient's test results, and the sampling working shift in Shahid Bahonar hospital in Kerman, Iran, in 2017 and 2018. Results: Among the tests, 0.2% had critical results. There was a significant relationship between the frequency of critical results with the patients' age (P = 0.002) and sex (P = 0.001) as well as with sampling working shift (P = 0.030) and admission ward (P = 0.001). Among the tests with critical values, the urea test was the most common with 32.2% critical value incidence. Conclusion: To maintain patient safety, proper recording of the results in laboratory tests and prompt reporting of critical values to the health care staff before repeating the test should be emphasized. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of the COVID19 pandemic, that has killed one million nine hundred people and infected more the 90 million until end of 2020, has been studied by many researchers. Here, we try to explain its biological behavior based on our recent autopsy information and review of literature. Methods: In this study, patients with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) result were considered eligible for enrollment. Histopathological examinations were done on 13 people who were hospitalized in Afzalipour hospital, Kerman, Iran. Clinical and laboratory data were reviewed. Tissue examination was done by light microscopy, immunohistochemistry and electron microscopy. Results: The most frequent co-morbidity in the patients was cardiovascular disease. The common initial symptoms of COVID-19 infection were dyspnea and cough. In all cases, the number of white blood cells was higher than the normal range. Common histopathological findings were variable degrees of vasculitis as degenerative to necrotic changes of endothelium and trafficking of inflammatory cells in the vessel wall with fibrinoid necrosis. Tissue damage included interstitial acute inflammatory cells reaction with degenerative to necrotic changes of the parenchymal cells. CD34 and Factor VIII immunohistochemistry staining showed endothelial cell degeneration to necrosis at the vessel wall and infiltration by inflammatory cells. Electron microscopic features confirmed the degenerative damages in the endothelial cells. Conclusion: Our histopathological studies suggest that the main focus of the viral damage is the endothelial cells (endotheliopathica) in involved organs. Also, our findings suggest that degeneration of leukocytes occurs at the site of inflammation and release of cytokines (leukocytoclastica) resulting in a cytokine storm. [ABSTRACT FROM AUTHOR]

Introduction: Adiponectin is an adipocyte-secreted protein that contributes to glucose homeostasis. Contradictory reports are available on single nucleotide polymorphisms (SNPs) in the adiponectin gene and the risk of type 2 diabetes (T2D). We investigate the association of adiponectin gene SNPs (+45T/G and +276G/T) with serum adiponectin, insulin resistance, lipid profile, and T2D risk in an Iranian population. Method: The +45T/G and +276G/T SNPs were genotyped in 211 non-familial T2D patients and 202 non-diabetic subjects by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and TaqMan probe, respectively. Results: T2D was associated with a decrease in serum adiponectin level. The G allele and the GG and TG genotypes of +45T/G SNP were more abundant than the T allele and the TT genotype in T2D patients compared with controls (p < 0.001). The risk of T2D in individuals with the GG and TG genotypes of +45T/G SNP was 4 and 2 times more than that with the TT genotype, respectively. There was no statistically significant difference in the frequencies of allele and genotype of +276G/T SNP between the control and T2D groups. The presence of +45G/+276G haplotype was associated with an increased risk of T2D (OR = 2.01, 95% CI = 1.34–3.03, p = 0.04). Conclusion: Therefore, our results showed that +45T/G SNP is associated with the risk of T2D higher than +276G/T SNP in the studied population. [ABSTRACT FROM AUTHOR]

Anthropometry is a scientific study of linear dimensions and angles of living subjects. Knowing the details and anthropometric properties of nasofacial for each specific ethnic group is important for cosmetic operation as well as identifying individuals. In this study, facial and nasal anthropometric factors were studied in students of Shiraz University of Medical Sciences. In a cross-sectional study, 200 students of Shiraz University of Medical Sciences (100 male and 100 female and age range of 18–30 years) were selected. Nasal width (NW), nasal length (NL), nasal height (NH), face height (FH) and face width (FW) were measured in and the nasal (NI) and facial index (FI) were calculated for each case. Then, the data were analyzed using SPSS-22. The mean age was 21.84 ± 3.18 years. There were significant differences in the facial and nasal measurements including FH (P = 0.0001), FW (P = 0.0001), FI (P = 0.0001), NL (P = 0.002), NH (P = 0.001), NW (P = 0.0001) and NI (P = 0.0001) of sex groups. The most common types of face were mesoprosopic (36%) and hyperleptoprosopic (38%) types and and platyrrhine (63%) were mostly frequent. Based on the findings, all students of Shiraz University of Medical Sciences had mesoprosopic (36%) and hyperleptoprosopic (38%) types of face and platyrrhine type of nose. As well, a sexual dimorphism was recorded according to the nasofacial measurements in Iranian population that should be considered in the cosmetic operations. Sexual dimorphism and differences between different populations were recorded. [ABSTRACT FROM AUTHOR]

Background: Bone marrow stromal cells (BMSCs), as a type of mesenchymal stem cells, and the granulocyte colony-stimulating factor (G-CSF), as a type of growth factor, may recover damaged ovaries. The aim of the present study was to investigate the effects of the coadministration of BMSCs and the G-CSF on damaged ovaries after creating a chemotherapy model with cyclophosphamide (CTX) in rats. Methods: The present study was performed in Semnan, Iran, in the late 2016 and the early 2017. BMSCs were cultured and were confirmed using the CD markers of stromal cells. Forty female Wistar rats were randomly divided into 4 groups. The rats were injected intraperitoneally with CTX for 14 days to induce chemotherapy and ovarian destruction. Then, the BMSCs were injected into bilateral ovaries and the G-CSF was injected intraperitoneally, individually and together. Four weeks later, the number of ovarian follicles using H&E staining, the number of apoptotic granulosa cells using the TUNEL assay, the number of produced oocytes from the ovaries, and the levels of serum E2 and FSH using an ELISA reader were assessed. Statistical analysis was done using one-way ANOVA with SPSS, version 16.0. Results: The results showed that the effects of the coadministration of 2x106 BMSCs and 70 µg/kg of the G-CSF were significantly more favorable than those in the control group (P<0.001), the BMSC group (P=0.016), and the G-CSF group (P<0.001) on the recovery of damaged ovaries. Conclusion: The efficacy ofthe coadministration of BMSCs and the G-CSF in the recovery of ovaries damaged by chemotherapy was high by comparison with the administration of either of them separately. [ABSTRACT FROM AUTHOR]

Background: Evidence has shown that cysteine protease enzymes, such as cathepsin D, cathepsin A, cathepsin K, and alpha-1 antitrypsin (AAT) are involved in the chronic degenerative joint process. This study aimed to determine the potential involvement of cathepsin K, cathepsin D, and AAT in patients with osteoarthritis (OA)., Methods: This study was performed on 31 patients with knee OA and 29 age- and sex-matched healthy subjects (both with Fars ethnicity from Iran). American College of Rheumatology (ACR) criteria were used to diagnose OA patients. The clinical status of the patients was scored by Western Ontario McMaster Universities Osteoarthritis (WOMAC), and pain intensity was measured by the Visual Analog Scale (VAS). The serum level of AAT was measured using high-resolution cellulose acetate electrophoresis. Additionally, serum levels of cathepsin D and cathepsin K were measured by enzyme-linked immunosorbent assay (ELISA)., Results: The findings showed that the serum level of cathepsin K was significantly increased in OA patients compared to healthy subjects (P = 0.01), while there was no significant difference between serum level of cathepsin D in study groups (P = 0.2). In addition, the serum concentration of AAT was significantly decreased in OA patients compared to healthy subjects (P = 0.003). There was a significant correlation between WOMAC score and age (r = 0.644, P = 0.0001) and VAS (r = 0.866, P < 0.0001) in OA patients., Conclusions: The decreased level of AAT in OA patients and a rise in serum level of cathepsin K are involved in the pathogenesis of OA via stimulation of bone resorption and cartilage degradation., (© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Since using tissue transplantation has faced limitations all over the world, regenerative medicine has introduced decellularized tissues as natural scaffolds and researchers are trying to improve their efficiency and function. In this study, to increase cell attachment and ultimately cell proliferation on decellularized bovine pericardia, scrophularia striata extract was used. Scrophularia striata is an Iranian traditional medicinal plant. For this aim after decellularization of bovine pericardium and analysis of its morphology, it was incubated in scrophularia striata solution. Next, isolated human adipose-derived mesenchymal stem cells were cultured on the tissue. Finally, MTT assay, nitric oxide assay, and scanning electron microscopy observation were performed. MTT showed an increase in cell survival after treating the tissue with the plant extract after 48 h in a dose dependent manner significantly. The survival of cells in 0.5%, 2.5%, and 5% groups was about 5, 10 and 15 folds higher in comparison to control groups, respectively. Additionally, nitric oxide secretion in 2.5% and 5% samples was three and five folds higher than that in control group, respectively. Moreover, SEM observation indicated an impressive and dose-dependent effect of using Scrophularia striata on tissue biocompatibility. The results of this study showed that using Scrophularia striata increased cell viability and cell attachment on decellularized pericardia which could pave the way for the use of natural extracts of medicinal plants to reduce unwanted effects and make desired changes in decellularized tissues., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Laboratory analysis errors in procedure or interpretation may be seen during the process of completing physician test orders. They may also result in rejection of the requests due to some applicability reasons. Hence, this study was carried out to determine the rate and reasons for such rejections in clinical settings., Methods: This cross-sectional comparative study was performed on 104008 laboratory tests in a one-year period in terms of the percentage and type of errors that occurred in Shahid Bahonar Hospital in Kerman, Iran, in 2018. The types of studied errors included hemolysis, sample clotting, insufficient sample size, and mistakes in labels or absence of labels on the sample., Results: In this study, 104008 laboratory tests were performed, with 2299 (2.21%) sample rejections, 456 (32.31%) complete blood count (CBC) sample clotting; 417 (29.38 %) hemolysis; and 150 (17.47 %) inadequate sample volume as the majority of errors. There was no statistically significant relationship between pre-analysis errors and clinical aspects ( P =0.124)., Conclusion: According to the results, it may be concluded that considering the high prevalence of laboratory errors in comparison with the majority of other studies, continuous training courses and determination of the causes of these errors are crucial to attaining better function and basic knowledge., (2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Cutaneous leishmaniasis (CL) is a neglected disease with important public health concerns in many parts of the world including Iran. We aimed to explore the histological changes and immunohistochemical quantification of inflammatory cells and their role in the immunopathology of acute, chronic non-lupoid, and chronic lupoid skin lesions in anthroponotic CL (ACL). In this study, skin biopsies of 53 patients with ACL were taken. Samples were studied by light microscopy and immunohistochemistry to quantify the immune and inflammatory cells. Of the 53 skin lesions, 38 were acute, nine chronic non-lupoid and six chronic lupoid. CD68+ macrophages were the most common cells. CD3+ T-lymphocytes were present as diffuse and focal dermal infiltrates and CD8+ cytotoxic T-lymphocytes were the dominant lymphocyte type, constituting more than 50% of the lymphocyte population. CD4+ T-lymphocytes in chronic non-lupoid (10.57 ± 2.37%) and chronic lupoid (14.40 ± 1.28%) lesions were more than those observed in the acute form (8.61 ± 1.31%), but the differences were not statistically significant. CD20+ B-lymphocytes constituted a small percentage of inflammatory cell infiltrates. CD1a + Langerhans cells showed progressively higher percentages from acute to chronic non-lupoid to chronic lupoid lesions. The differences were statistically significant (P < 0.05) between acute and chronic lupoid lesions. CD68 + macrophages were the most common cells and CD8+ T lymphocytes remained the predominant T-lymphocytes in acute, chronic non-lupoid, and chronic lupoid lesions, suggesting their central role in the pathogenesis and possible healing of CL. Focusing on the deep dermis, periadnexal and/or peripheral margins or even papillary tip of inflammatory sites of sandfly bites, we sometimes find granuloma inside lymphatic vessels (lymphangiectatic metastatic granuloma) or even infected macrophages with engulfed Leishman bodies faraway. Knowledge of the histopathological and immunohistochemical findings for various forms of ACL is essential in improving clinical and medical strategies and crucial for proper prophylactic and therapeutic plans. • Cutaneous leishmaniasis is a neglected disease with important public health concerns. • Biopsies of ACL patients were studied to quantify the immune and inflammatory cells. • Of the 53 skin lesions, 38 were acute, nine chronic non-lupoid and six chronic lupoid. • CD68+ macrophages were the most common cells. • Knowledge of the various forms of ACL is essential in improving medical strategies. [ABSTRACT FROM AUTHOR]