Mucosal leishmaniasis with primary oral involvement: a case series and a review of the literature

Abstract

The literature analysis revealed that in immunocompetent patients, the oral mucosa is the second most frequently affected site of the head and neck region. In the oral cavity, the tongue is the most affected site. Diagnosis of oral leishmaniasis represents a challenge but must be considered in any differential diagnosis of exophytic lesions of oral mucosa.

Exclusive Primary Lesion of Oral Leishmaniasis with Immunohistochemical Diagnosis

“…The reason why few patients with CL subsequently develop ML is not known [14]. Leishmaniasis with exclusive and primary involvement of the mucosa is very rare, and in the oral cavity is an even more rare event [9], but it can occur by the fact that L. braziliensis spreads to distant sites during an early phase of infection, before the appearance of skin lesions [15].…”

“…Mignogna et al [9] reported that ML is rare in immunocompetent patients. However, in the current review (Table 1), we found that leishmaniasis with exclusive primary involvement of the oral mucosa was more frequent in immunocompetent patients (14 cases, 70.0 %).…”

“…Here, we find that most cases (55.0 %) were treated with pentavalent drugs for 20 to 40 days, but other treatments were used including amphotericin B and miltefosine. According to Mignogna et al [9], patients affected by ML should be managed to achieve complete healing and a long follow-up period without signs or symptoms, the possibility of relapses has to be considered. In the present case, there was no recurrence after a follow-up of 4 years.…”

“…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.…”

“…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].…”