Lip leishmaniasis: a case series with molecular identification and literature review

Abstract

BackgroundMucocutaneous leishmaniasis (MCL), a protozoan infectious disease, is very rare in Iran despite the endemicity of both cutaneous and visceral forms. It is transmitted by the Phlebotomus sand fly. The lip is considered one of the extraordinary sites. Lesions usually initiate with erythematous papules, slowly enlarges and then it ulcerates. The diagnosis of MCL encompasses epidemiological, clinical and laboratory aspects. Usually, the combination of some of these elements is necessary for the final diagnosis. So, lip leishmaniasis lesions can be challenging to diagnose.Case presentationWe presented seven rare cases of lip leishmaniasis. Tissue impression smear, culture, PCR and phylogenetic analysis were carried out for explicit diagnosis. Skin scraping investigation showed several Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for L. major, L. tropica, and L. infantum. Differential diagnosis includes orofacial granulomatosis, basal cell carcinoma, squamous cell carcinoma, and mesenchymal tumors. The cases were treated with systemic meglumine antimoniate (Glucantime®). No relapses were observed during 1 year of follow-up. Early detection of the infection are necessary in order to start effective treatment and prevent more serious complications.ConclusionsIn this paper, we reported seven rare cases of lip leishmaniasis in Iran, emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic kinship of isolated parasites, and reviewed the literature on lip leishmaniasis.

Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial

“…AccuPrep ® Genomic DNA Extraction Kit (Bioneer, Daejeon, Korea), was performed to extract genomic DNA from each clinical sample, according to the manufacturer’s instructions. Special primers related to variable regions of kDNA were used in PCR analysis as previously described [ 49 , 50 ].…”

Differentiation of mucosal lesions in mucocutaneous leishmaniasis and paracoccidioidomycosis

“…Besides the clinical manifestations, leishmaniasis and paracoccidioidomycosis also partially overlap in their territorial distributions [ 6 ], with both being endemic in similar regions of Latin America [ 2 , 4 ]. Health professionals, even in non-endemic countries, must be acutely aware of the differential diagnosis of orofacial lesions, especially because of the increase in travel to endemic areas [ 10 ].…”

Dudakta leishmaniasis: 20 hastanın değerlendirilmesi

“…Intralesional antimony therapy may cause a burning sensation, pain, and vasovagal reactions. 1,20 Other therapeutic agents used in the treatment of ML include liposomal amphotericin B, pentamidine, oral azole compounds and miltefosine. [28][29][30] In a ML case reported in Sudan, upper lip, larynx, palate and gingiva involvement was detected and this patient was successfully treated with intravenous sodium stibogluconate.…”