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 65-year-old woman was referred to the Fajr Health Center. The chief complaint was a lip lesion that began 2 months prior as a slowly enlarging nodule. Patient reported that the lesion began as a small soft mass, which ulcerated later. Clinical examination showed a necrotic ulcer of the left lower lip vermillion. The lip was erythematous and edematous from midline to the left commissure mediolaterally (Fig. ). With suspicion of basal cell carcinoma and squamous cell carcinoma, skin scraping, culture, and PCR were accomplished. Touch impression smears and culture were positive and the parasite was characterized by PCR as L. tropica.