Value of touch preparations (imprints) for diagnosis of cutaneous leishmaniasis

Background. The clinical diagnosis of cutaneous leishmaniasis is confirmed by demonstrating the organism on a superficial smear or on a biopsy of the lesion. Misdiagnosis in a biopsy specimen may be due to scanty Leishmania organisms that may not be identified in histologic sections. Methods. Punch biopsies of skin lesions, suspected clinically to be cutaneous leishmaniasis, from 29 patients were taken. Touch smears on slides were air-dried, fixed with methyl alcohol, and stained with Giemsa stain. Results of routine histologic examination were then compared with those of touch preparation. Results. Twenty-one cases were positive for leishmaniasis. In 18 cases, the organisms were seen both in the biopsy and in the touch preparation. In three cases, the organisms were only identified on touch preparation. Conclusions. A touch preparation improves the sensitivity of the diagnosis of cutaneous leishmaniasis without incurring additional cost to the laboratory.