Mucocutaneous Leishmaniasis: clinical markers in presumptive diagnosis

Abstract

Mucocut aneous Leishmaniasis (ML) can lead to serious sequela; however, early diagnosis can prevent complications. Aim:To evaluate clinical markers for the early diagnosis of ML. Materials and Methods:A series study of 21 cases of ML, which were evaluated through clinical interview, nasal endoscopy, biopsy and the Montenegro test.Results: A skin scar and previous diagnosis of cutaneous leishmaniasis (CL) were reported in 8(38%) patients, and 13(62%) of them denied having had previous CL and had no scar. Nasal/oral symptom onset until the ML diagnosis varied from 5 months to 20 years, mean value of 6 years. In the Montenegro test, the average size of the papule was 14.5 mm, which did not correlate with disease duration (p=0.87). The nose was the most often involved site and the extension of the injured mucosa did not correlate with disease duration. The parasite was found in 2 (9.52%) biopsy specimens.Conclusions: ML diagnosis was late. Finding the parasite in the mucosa, cutaneous scar and/ or previous diagnosis of CL were not clinical markers for ML. ML diagnosis must be based on the Montenegro test, chronic nasal and/or oral discharge and histological findings ruling out other granulomatous diseases. Braz J Otorhinolaryngol. 2011;77(3):380-4. ORIGINAL ARTICLE BJORL

Stigmata in cutaneous leishmaniasis: Historical and new evidence-based concepts

“…However, literatures measuring the stigmata arising from CL in some endemic geographical areas in Asia, Africa, South America and Europe have not existed [19].…”

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“…8,10 More than 90% of mucosal injuries affect only the anterior nasal septum. 8,9,11 This condition can severely compromise the nose, palate, gums, pharynx, and larynx, causing deformities that impair phonation, breathing, swallowing, and self-esteem. 8,10,11 Factors related to the parasite, host, and magnitude of the immune response are relevant to mucosal damage.…”

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