Mucocutaneous leishmaniasis

Abstract

Leishmaniasis is a parasitosis caused by protozoa of the genus Leishmania (L.) transmitted by the bite of the sandfly Phlebotomus [1]. In Morocco, there exist three species: L. infantum, L. major, and L. tropica, most often responsible for the cutaneous and visceral forms. Mucosal involvement is rare and responsible for invasive, destructive, and treatment-resistant lesions [2]. Herein, we report a case of mucocutaneous leishmaniasis with different epidemiological and clinical characteristics from those of the New World. A nineteen-year-old female patient from the South (Essaouira, Morocco), without any particular personal history, with a father treated for cutaneous leishmaniasis one year ago, consulted for cutaneous and mucosal lesions that appeared eight months previously, painless, non-pruritic, beginning with an erythematous papule that progressively increased in size, with an ulcerated surface and an infiltrated base, two on the lower lip (Fig. 1a), and ten distributed between both forearms (Fig. 1b) and both legs. Direct examination for Leishman bodies was positive on the two oral mucosal lesions and one skin lesion. HIV serology was negative. The patient received meglumine antimoniate for twenty-one days, combined with cryotherapy sessions, with a good evolution without any detectable side effects.