An 8-year-old girl presented to the Leishmaniasis research laboratory of the Fajr Health Center with complaint of wound on her upper lip. The lesion started 3 months prior as a small nodule in the center of the upper lip which slowly enlarged over a few weeks and then ulcerated. Clinical examination showed an indurated, crusted, and scaled necrotic ulcer with swelling on the midline of the upper lip, extending to the vermilion. There was purulent discharge from the lesion (Fig. f). With suspicion of cheilitis granulomatosa, slit dermal scraping, culture and PCR were performed. Giemsa-stained smear and culture were positive. PCR portrayed the parasite as L. major.
A 10-year-old girl was referred to the Dermatology Clinic of Saadi Hospital. The patient had become infected with CL on the left side of her mentum 3 months before. Three weeks prior to referral, the lesion had spread to the mucosal part of the lower lip. The patient improved diffuse severe swelling of the lower lip. On physical examination, erythema, ulceration, and scaling of the left side of the mentum were detected. There was a diffuse swelling cheilitis of the lower lip extra to ulceration and bleeding of the labial mucosa (Fig. ). Giemsa-stained smears and culture were positive. PCR identified the parasite as L. major.