TOXOPLASMOSIS MIMICKING ACTINIC CHEILITIS: A CASE REPORT

Abstract

A 33-year-old man sought treatment after presenting with an ulcerated lesion on the lower lip, symptomatic and associated with a history of fever and 1 year of evolution. The echoscopic examination showed evidence of solar lentigines on the face and symptomatic lymphadenopathy in the right submandibular region. Ulcerative lesions on the lower lip (mimicking actinic cheilitis) and maxillary vestibular fundus were observed by oroscopic examination. The initial hypotheses were infectious disease or an immunologically mediated process. Exfoliative cytology, incisional biopsy and hemogram, serologies for HIV and toxoplasmosis, and venereal disease research laboratory and Mantoux tests were performed. Histopathologically, nonspecific chronic inflammatory infiltrate was observed, and hematologic and serologic tests were normal, except IgM and IgG anti-toxoplasma were both positive. The cytology evidenced structures suggestive of bradyzoites and tachyzoites leading to the final diagnosis of toxoplasmosis. The patient was treated with sulfadiazine, pyrimethamine, and folinic acid. He is currently being followed up with complete remission of the lesions. A 33-year-old man sought treatment after presenting with an ulcerated lesion on the lower lip, symptomatic and associated with a history of fever and 1 year of evolution. The echoscopic examination showed evidence of solar lentigines on the face and symptomatic lymphadenopathy in the right submandibular region. Ulcerative lesions on the lower lip (mimicking actinic cheilitis) and maxillary vestibular fundus were observed by oroscopic examination. The initial hypotheses were infectious disease or an immunologically mediated process. Exfoliative cytology, incisional biopsy and hemogram, serologies for HIV and toxoplasmosis, and venereal disease research laboratory and Mantoux tests were performed. Histopathologically, nonspecific chronic inflammatory infiltrate was observed, and hematologic and serologic tests were normal, except IgM and IgG anti-toxoplasma were both positive. The cytology evidenced structures suggestive of bradyzoites and tachyzoites leading to the final diagnosis of toxoplasmosis. The patient was treated with sulfadiazine, pyrimethamine, and folinic acid. He is currently being followed up with complete remission of the lesions.