Abstract

The dental surgeon plays a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had mucocutaneous leishmaniasis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dental surgeon. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination.

Highlights

  • The dental surgeon plays a fundamental role in the early diagnosis of oral leishmaniasis

  • - We emphasize that these lesions are rare in the oral mucosa, it cannot be ruled out as a differential diagnosis, considering mainly, when such lesions occur in endemic regions as all reported cases

  • The dental surgeon can contribute to early diagnosis of mucosal lesions, since oral mucosa may be the primary site of the disease manifestation

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Summary

29 May 2019 report report report report report

Any reports and responses or comments on the article can be found at the end of the article. Case 1 Male, 24-years-old, Caucasian, unemployed, from Tancredo Neves, State of Bahia, Brazil, was admitted to the University Hospital, in January 2012, presenting diffuse bullous lesions on the body, osteoarthritis of the distal interphalangeal joints and proteinuria 399 mg/day (reference value >150mg/day). In August 2013, in outpatient medical consultation, the lesions were observed in nasal mucosa and palate He was followed up in the outpatient clinic and treatment with glucantime 20 mg/kg/day was prescribed for one month. In 2013, the patient was admitted with submandibular lymphadenopathy and ulcerated lesions in the lower lip frenulum (Figure 1d), gingiva, nasal septum and in the back region She was hospitalized for diagnosis and treatment of lesions with liposomal amphotericin B. Treatment was replaced by the liposomal form at a dose of 100 mg/day and patient was discharge one month later with complete remission of lesions. The patient has not yet returned for evaluation as they are receiving antineoplastic treatment outside our hospital

Discussion
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World Health Organization
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