Mucosal leishmaniasis of the lip: an emerging clinical form in Tunisia

Hammami-Ghorbel, Houda; Abda, I. Ben; Badri, Talel; Chelbi, Hanène; Fenniche, Samy; Mokhtar, I.; Bouratbine, A.; Benmously-Mlika, Rym; Karim, Abdul

doi:10.1111/jdv.12580

Cited by 16 publications

(11 citation statements)

References 18 publications

(49 reference statements)

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“…donovani in Syria has been suggested but still not demonstrated [ 50 ], k Syria exhibits the highest prevalence of CL in the Mediterranean region: 53,000 CL cases were reported in 2012 and 41,000 CL cases in the first 6 months of 2013 [ 94 ], l L . donovani is a suspected agent of CL in Israel and Palestine [ 2 , 100 ], m An emerging clinical form, ML of the lip, was recently observed in Tunisia [ 109 ] Abbreviations : CL, cutaneous leishmaniasis; ML, mucosal leishmaniasis; N, no; SFNV, Sandfly fever Naples virus; SFSV, Sandfly fever Sicilian virus; TOSV, Toscana virus; VL, visceral leishmaniasis; Y, yes …”

Section: Human Infection Caused By Phlebotomine Sand Fly–borne Pathogmentioning

confidence: 99%

Phlebotomine sand fly–borne pathogens in the Mediterranean Basin: Human leishmaniasis and phlebovirus infections

et al. 2017

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Pathogens transmitted to humans by phlebotomine sand flies are neglected, as they cause infectious diseases that are not on the priority list of national and international public health systems. However, the infections caused by protozoa of the Leishmania genus and viruses belonging to the Phlebovirus genus (family Phenuiviridae)—the most significant group of viruses transmitted by sand flies—have a relevant role for human pathology. These infections are emerging in the Mediterranean region and will likely spread in forthcoming decades, posing a complex threat to human health. Four species and 2 hybrid strains of Leishmania are pathogenic for humans in the Mediterranean Basin, with an estimated annual incidence of 239,500–393,600 cases of cutaneous leishmaniasis and 1,200–2,000 cases of visceral leishmaniasis. Among the phleboviruses, Toscana virus can cause neuroinvasive infections, while other phleboviruses are responsible for a typical “3-day fever”; the actual incidence of Phlebovirus infections in the Mediterranean area is unknown, although at least 250 million people are exposed. Here, we reviewed the current literature on epidemiology of sand fly–borne infections in the Mediterranean Basin, with a focus on humans. Our analysis indicates the need for increased public health activities directed to determine the disease burden of these infections as well as to improve their surveillance. Among the emerging challenges concerning sand fly–borne pathogens, the relationships between sand fly–borne protozoa and viruses should be considered in future studies, including epidemiological links between Leishmania and phleboviruses as well as the conditional capacity for these pathogens to be involved in interactions that may evolve towards increased virulence.

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Section: Human Infection Caused By Phlebotomine Sand Fly–borne Pathogmentioning

confidence: 99%

Phlebotomine sand fly–borne pathogens in the Mediterranean Basin: Human leishmaniasis and phlebovirus infections

et al. 2017

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“…Indeed, Karamian et al [17] have described the clinical features of 6 CL cases infected with L. major and 3 cases infected with L. tropica . Hammami-Ghorbel et al [18] investigations have studied the clinical polymorphism within an endemic focus without an accurate identification of the Leishmania species.…”

Section: Clinical Presentation Of Cutaneous Leishmaniasis Caused By Lmentioning

confidence: 99%

Clinical Presentation of Cutaneous Leishmaniasis caused by <b><i>Leishmania major</i></b>

Remadi

Haouas²,

Chaara³

et al. 2016

Dermatology

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Background/Aims: The diagnosis of cutaneous leishmaniasis (CL) is based on the microscopic detection of amastigote, isolation of the parasite, or the detection of Leishmania DNA. Nevertheless, since these techniques are time consuming and not usually available in many endemic countries, the diagnosis remains clinical. Consequently, such disease may be overlooked because of its similarity to other skin diseases. The aim of this study is to describe the clinical polymorphism of CL caused by Leishmaniamajor.Methods: A cross-sectional survey was carried out on 166 patients. Diagnoses were made by both microscopic examination of stained tissue-scraping smears and PCR. The Leishmania species was identified by restriction enzyme analysis of the ribosomal internal transcribed spacer 1 region. The clinical polymorphism was analyzed only for patients with a positive diagnosis for CL and L. major as the identified species. Results and Conclusion: Of the 166 patients, 75 patients fit the inclusion criteria. Twelve different types of CL caused by L. major were defined. The most common type was the ulcero-crusted form followed by the papulonodular form and the impetigenous form. The ulcerated, mucocutaneous, lupoid, and sporotricoid forms were less common. The eczematiform, erysipeloid, verrucous, psoriasiform, and pseudotumoral types were represented by a single case. Zoonotic CL caused by L. major can simulate many other skin diseases, which may lead to a significant spread of this disease and increases in morbidity and drug resistance. This large polymorphism may be the result of a complex association between the genetics of the parasite and the immune response of the host.

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“…Mucosal involvement is rarely seen in the Old World cutaneous leishmaniasis. It is typically seen with infection by Leishmania species found in South America 9 . Mucosal leishmaniasis of the lip is rare and was recently reported as an emerging clinical form in Tunisia.…”

Section: Discussionmentioning

confidence: 99%

“…Mucosal leishmaniasis of the lip is rare and was recently reported as an emerging clinical form in Tunisia. It is commonly related to Leishmania infantum 9 . It is caused by an extension by contiguity from a skin lesion or by direct inoculation of the mucosa 10 .…”

Section: Discussionmentioning

confidence: 99%

Chronic macrocheilia: a clinico‐etiological series of 47 cases

et al. 2021

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Background Macrocheilia is an inflammatory disfiguring condition responsible for the swelling of the lips. This multi‐etiological entity represents a diagnostic and therapeutic challenge. Published data on macrocheilia is scarce, often limited to granulomatous cheilitis. Methods We conducted a retrospective study, including all patients presenting with chronic macrocheilia (CM) for nineteen years. CM was defined as a persistent enlargement of one or both lips for at least eight weeks. Both descriptive and analytical analyses were performed. Results Of the 47 patients identified, 20 (43%) had cutaneous leishmaniasis, 10 (21%) had Miescher's cheilitis, five (11%) had Melkersson–Rosenthal syndrome, five (11%) had sarcoidosis, one (2%) had lepromatous leprosy, one (2%) had systemic amyloidosis, and one (2%) had Crohn's disease. In four cases, the CM was unlabeled. Ulcerations were significantly associated with leishmaniasis (P < 0.05). Histological study showed a granulomatous infiltrate in 72% of cases. Medical treatment was adapted to the etiology of CM. Surgery was performed in two cases. Improvement of CM secondary to leishmaniasis was seen in all cases. In patients with idiopathic orofacial granulomatosis, partial improvement was noted in four cases and a total improvement in one case. Recurrences were noted in three cases after complete regression. Conclusions Macrocheilia is a rare and disfiguring condition that requires an etiological investigation, considering that it can reveal a serious underlying systemic disease. We identified several factors that could help recognize the cause of CM, including age, history of intermittent swelling, the extent of lip enlargement, the existence of ulceration, and systemic symptoms.

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Mucosal leishmaniasis of the lip: an emerging clinical form in Tunisia

Cited by 16 publications

References 18 publications

Phlebotomine sand fly–borne pathogens in the Mediterranean Basin: Human leishmaniasis and phlebovirus infections

Phlebotomine sand fly–borne pathogens in the Mediterranean Basin: Human leishmaniasis and phlebovirus infections

Clinical Presentation of Cutaneous Leishmaniasis caused by <b><i>Leishmania major</i></b>

Chronic macrocheilia: a clinico‐etiological series of 47 cases

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