Gingival leishmaniasis in an HIV-negative patient

Palmeiro, Mariana Reuter; Rosalino, Claúdia Maria Valette; Quintella, Leonardo Pereira; Morgado, Fernanda Nazaré; Martins, Ana Cristina da Costa; Moreira, João; Schubach, Armando de Oliveira; Conceição-Silva, Fátima

doi:10.1016/j.tripleo.2007.07.008

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…We found only 19 cases of leishmaniasis, with involvement reported exclusively in the oral area in the English-language literature [3][4][5][6][7][8][9][10][11][12][13], and 6 cases in immunocompromised patients [3,[5][6][7]. These lesions usually appear as erythema and ulceration or as plaque, papules, and/or exophytic nodules, usually affecting the hard or soft palate and tongue.…”

Section: Introductionmentioning

confidence: 99%

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Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

Almeida

Silveira

Santos

et al. 2016

Head and Neck Pathol

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A case of oral leishmaniasis without cutaneous involvement affecting the upper alveolar ridge mucosa/ gingiva and the hard palate is reported in a 41-year-old Brazilian man. Microscopic examination disclosed scarce amastigotes and the definitive diagnosis was facilitated by immunohistochemical analysis. The clinical presentation of this lesion is unusual and underlies the importance of considering leishmaniasis in the differential diagnosis of oral lesions, especially in endemic areas. A literature review of the cases of mucosal leishmaniasis with exclusive primary lesions of the oral mucosa was also performed.

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Section: Introductionmentioning

confidence: 99%

“…These lesions usually appear as erythema and ulceration or as plaque, papules, and/or exophytic nodules, usually affecting the hard or soft palate and tongue. However, they can affect any site such as the lip, uvula, gingiva, tonsil, and retromolar region [5,6,9,11].…”

Section: Introductionmentioning

confidence: 99%

Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

Almeida

Silveira

Santos

et al. 2016

Head and Neck Pathol

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“…The cutaneous form is the most prevalent and is characterised by the presence of ulcers with a well‐defined erythematous border and a central crust that is often haemorrhagic, located in exposed areas of the body and ranging in number from 1 to 10 2,7 . The mucocutaneous form is the most severe and presents clinically a few years following the manifestation of the cutaneous form, affecting the upper aerodigestive tract, with lesions mainly in the oral and nasal mucosa and occasionally in the laryngeal and pharyngeal mucosa 7–9 . These lesions are generally associated with pain, oedema, a fetid odour, bleeding and sialorrhea 9 .…”

Section: Introductionmentioning

confidence: 99%

Leishmaniasis with oral mucosa involvement

et al. 2012

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Introduction:The term leishmaniasis comprises a group of diseases caused by different protozoan species of the genus Leishmania. There are three main clinical forms of leishmaniasis: visceral, cutaneous and mucocutaneous. Exclusive involvement of the mucosa is very rare. Objectives: To present a case of mucocutaneous leishmaniasis in an elderly patient, discuss the clinical presentation, diagnostic process and treatment emphasizing the distinctions from other granulomatous lesions. Case report: A 71-year-old male presenting with a symptomatic lesion on the hard and soft palate, which had developed over a period of 6 months was evaluated. The oral exam revealed a lesion with multiple ulcerated nodules on the hard and soft palate extending to the oropharynx. The diagnostic hypothesis was chronic infectious disease (paracoccidioidomycose, tuberculosis and leishmaniasis) or squamous cell carcinoma. Histopathological, histochemical and immunohistochemical analysis were performed. A chest x-ray revealed a normal pulmonary pattern. The Montenegro skin test was positive. The definitive diagnosis was leishmaniasis with exclusive oral manifestation and the patient was treated with liposomal amphotericin. Conclusions: Localized oral mucosa leishmaniasis is an uncommon event in an immunocompetent patient. Dentists play an important role in the diagnosis of oral leishmaniasis, which has systemic repercussions.

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“…The most common clinical presentation is the presence of cutaneous lesions (2). However, about 3–5% of patients infected with Leishmania ( Viannia ) braziliensis progress to mucosal leishmaniasis, which mainly affects nasal, oral and laryngeal mucosae (2–4). They are characterized by difficulties in parasite identification and large tissue destruction (5–7).…”

Section: Introductionmentioning

confidence: 99%

“…Oral lesions frequently involve the lip and palate, although lesions in the uvula, gingiva, tonsils and tongue are reported. The oral mucosa generally appears swollen, ulcerated with a granular bottom and/or presents ulcerovegetative lesions (2–4). To our knowledge, few studies have investigated the in situ immune response in mucosal leishmaniasis (4,6,8–13), and there are no studies comparing the inflammatory activity between nasal and oral infected or healthy mucosae.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of the in situ immune response in oral and nasal mucosal leishmaniasis

Palmeiro

Morgado

Valete‐Rosalino

et al. 2011

Parasite Immunology

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Mucosal Leishmaniasis (ML) may occur in both nasal and oral mucosa. However, despite the impressive tissue destruction, little is known about the oral involvement. To compare some changes underlying inflammation in oral and nasal ML, we performed immunohistochemistry on mucosal tissue of 20 patients with ML (nasal [n = 12]; oral [n = 8] lesions) and 20 healthy donors using antibodies that recognize inflammatory markers (CD3, CD4, CD8, CD22, CD68, neutrophil elastase, CD1a, CLA, Ki67, Bcl-2, NOS2, CD62E, Fas and FasL). A significantly larger number of cells, mainly T cells and macrophages, were observed in lesions than in healthy tissue. In addition, high nitric oxide synthase 2 (NOS2) expression was associated with a reduced detection of parasites, highlighting the importance of NOS2 for parasite elimination. Oral lesions had higher numbers of neutrophils, parasites, proliferating cells and NOS2 than nasal lesions. These findings, together with the shorter duration of oral lesions and more intense symptoms, suggest a more recent inflammatory process. It could be explained by lesion-induced oral cavity changes that lead to eating difficulties and social stigma. In addition, the frequent poor tooth conservation and gingival inflammation tend to amplify tissue destruction and symptoms and may impair and confuse the correct diagnosis, thus delaying the onset of specific treatment.

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Gingival leishmaniasis in an HIV-negative patient

Cited by 12 publications

References 21 publications

Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

Leishmaniasis with oral mucosa involvement

Comparative study of the in situ immune response in oral and nasal mucosal leishmaniasis

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