Abstract
Dentists play 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 leishmaniasis diagnosis 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 dentist. 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
Dentists play a fundamental role in the early diagnosis of oral leishmaniasis
In the Discussion Paragraph 4 We changed the sentence “Leishmaniasis should be considered in immunocompromised patients” for the sentence “Unusual manifestations as disseminated leishmaniasis (DisL) or purely oral Leishmaniasis should be considered in immunocompromised patients”
Unusual manifestations as DisL or purely oral Leishmaniasis should be considered in immunocompromised patients[13–16]
Summary
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
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