2019, Number 1
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ABSTRACTAccording to the World Health Organization (WHO), leishmaniasis is one of the seven most important tropical diseases that represents a global health problem and yet one of the most neglected diseases. Approximately 350 million people are at risk of contracting the disease and it is estimated that 1.6 million new cases occur worldwide each year. We present the case of a 32-year-old male patient who was referred with a 3-month old lesion on lips, which started as a “small ball” in the lower lip and progressively extended, increasing in size and ulcerating until the whole upper lip was covered. At the time of evaluation, he presented with stomatitis located in the lips (upper and lower) constituted by edema, ulcers, crusts and yellowish discharge. The patient had recently traveled to Peten, Guatemala, which is an endemic area of leishmaniasis. Lower lip biopsies were performed and sent to the Central Unit for PCR-DNA analysis at the National Health Laboratory. The PCR-DNA test confirmed the diagnosis of leishmaniasis due to Leishmania sp. and treatment was started with glucantime at a dose of 20 mg/kg/day for 20 days intramuscularly, obtaining an excellent clinical response. Leishmaniasis lesions occur in areas of the body exposed to the bite of sand flies (Plhebotomus and Lutzomyia). The most involved areas of the body are the ears, cheeks, nose, and extremities. Labial leishmaniasis as the primary site of cutaneous leishmaniasis is unusual and can mimic other pathologies such as oral granulomatosis in Crohn’s disease, sarcoidosis, giant cell granuloma, squamous cell carcinoma, fungal infections among others. Although labial lesions are an unusual presentation of leshmaniasis, it’s important to consider it under the differential when patients have travelled to endemic areas so that early diagnosis and timely treatment can be started.
Antonio LF, Fagundes A, Oliveira RV, Pinto PG, Bedoya-Pacheco SJ, Vasconcellos EC, Valete-Rosalino MC, Lyra MR, Passos SR, Pimentel MI y Schubach AO, Montenegro skin test and age of skin lesion as predictors of treatment failure in cutaneous leishmaniasis, Rev Inst Med Trop Sao Paulo 2014; 56(5):375-80.