A 40-year-old, generally healthy woman complained of persistent lip enlargement and sore that appeared after several days of fever and had been present for 2 months. At clinical examination, the left side of the upper lip appeared erythematous and distended, with overlying yellow crusting lesion extending to the wet line. No lymphadenopathy was associated (Fig. ). Giemsa-stained smears and culture were positive (Fig. ). PCR identified 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.