A 62-year-old male patient, rural worker, smoker, and chronic alcohol user, HIV negative, was referred to the stomatology clinic with upper lip and upper alveolar ridge lesions present for 2 months. During anamnesis, sudden weight loss was reported. Medical history recorded no other important data. Extraoral physical examination showed a cutaneous lesion in the left thigh region [] and along with ulcerated lesions of the nasal mucosa. Cervical lymphadenopathy was undetected on palpation.\nPhysical intraoral examination revealed ulcerated and irregular lesions in the mucosa of upper alveolar ridge and palate [Figure and ]. An incisional biopsy was performed under local anesthesia considering a differential diagnosis with paracoccidioidomycosis, tuberculosis and leukemia.\nSerologies for histoplasmosis and toxoplasmosis were subsequently requested, both resulting in non-reactive antibodies. Therefore, mucocutaneous leishmaniasis was suspected. Histopathologic data showed a non-specific chronic inflammatory process. Immunohistochemistry procedures revealed cells positive for CD68 and Leishmania antigen [Figure and ]. In addition, the positivity of the IDRM test proved the hypothesis. Treatment, therapeutic response and follow-up of this patient were similar to those cited for the previous patient.
A 75-year-old woman came to the Dermatology Clinic of Saadi Hospital complaining about a lesion on his right lower lip. She reported that the lesion appeared about 3 months before. The clinical examination revealed a round nodular lesion in the right lower lip which was slightly shiny and red colored. Palpation of the lesion revealed a firm consistency (Fig. ). The differential diagnosis of a nodular lesion of the lip included: neoplasia (basal cell carcinoma), and tumors from mesenchymal origin (fibroma, lipoma, and neuroma). Giemsa stain and culture were negative. PCR depicted the parasite as L. tropica.