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  In this article
   Abstract
   Introduction
   Case Report
   Discussion
   References
   Article Figures

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CASE REPORT
Year : 1995  |  Volume : 61  |  Issue : 5  |  Page : 303-304

Lip leishmaniasis




Correspondence Address:
S Criton


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Source of Support: None, Conflict of Interest: None


PMID: 20952998

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  Abstract 

A case of leishmaniasis of lip without any involvement of other parts of the body in a 36 year-old-male is described


Keywords: Leishmaniasis, LD bodies


How to cite this article:
Criton S, Sridevi P K, Asokan P U. Lip leishmaniasis. Indian J Dermatol Venereol Leprol 1995;61:303-4

How to cite this URL:
Criton S, Sridevi P K, Asokan P U. Lip leishmaniasis. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Dec 10];61:303-4. Available from: http://www.ijdvl.com/text.asp?1995/61/5/303/4249



  Introduction Top


Leishmaniasis is a parasitic disease caused by different species of Leishmania and is transmitted by sand fly bites. In India, cutaneous leishmaniasis occurs mostly in North-Western region. In 1990 an indigenous case of cutaneous leishmaniasis had been described from Kerala.[1] A few case of leishmaniasis of lip have been described by Khaled El-Hoshy[2] and Asvesti et al.[3] The description of a case of leishmaniasis solely involving the lip from India is for the first time.


  Case Report Top


A 36-year-old carpenter presented with a history of ulceration of lower lip for 2 years [Figure - 1]. Earlier he was diagnosed as having Hansen's Disease Type I reaction and treated accordingly.

Examination showed a moderately built man with sewlling of the lower lip. There was ulceration involving the whole of mucosal surface of lower and upper lips extending to the mucocutaneous junction. The floor was covered with granulation tissue. Some areas showed crusting. The lower lip was indurated. The angles of mouth were spared. There was regional lymphadenopathy. The lymph nodes were nontender, mobile, soft and discrete. No other lymph node groups were enlarged. No evidence of cutaneous leishmaniasis was seen anywhere else. Systemic examination revealed no abnormality.

Complete haemogram and urinalysis were within normal limits. Skiagram of chest was normal. Mantoux test was within normal limits. Tissue smears showed Leishman-Donovan (LD) bodies and histopatholigical examination showed granulomas with multinucleated giant cells. [Figure - 2]. Some areas showed histiocytes with LD bodies.

The patient was treated with sodium antimony gluconate injection intramuscularly 200mg/d for 20 days. Patient responded very well [Figure - 3].


  Discussion Top


Lip swelling is seldom mentioned as a presentation of cutaneous Leishmaniasis. The initial cutaneous lesions are small papules that may develop into nodules that either ulcerate or become verrucous and/or nodular plaques. Most primary cases heal spontaneously[4] The lesions in the mucocutaneous stage ranged from simple oedema of lips and nose to perforation of cartilage of the nose and larynx.[4] The reasons of only selected patients having mucosal lesions remain unknown. But it may be associated with defective macrophage function, macrophage resistant strains of Leishmania and decreased production of lymphokines, especially interferon. Other factors that may influence that development of lesions in mucocutaneous leishmaniasis include increased delayed hypersensitivity, duration and size of the lesion in primary phase, association of tuberculosis and diabetes.[4] In the present case there is no evidence or history of cutaneous leishmaniasis. There is no evidence of diabetes or tuberculosis. The lesion started and remained confined to the lip and hence the rarity.



 
  References Top

1.Mohammed K, Narayani K, Aravinda K. Indigenous cutaneous leishmaniasis. Ind J Dermatol Venereol Leprol 1990;56:228-9.  Back to cited text no. 1    
2.Khaled El. Hoshy Lip leishmaniasis. J Am Acad Dermatol 1993;28:661-2.  Back to cited text no. 2    
3.Asvesti C, Anastassiadis G, Kolokotronis A, Zographakis I. Leishmania tropica of lip. Oral Surg, Oral Med, Orla Pathol, 1992;73:56-8.  Back to cited text no. 3  [PUBMED]  
4.Sanguezaops, Sangueza JM, Stiller MJ, Pastro Sangueza P, La Paz. Mucooutaneous leishmaniasis: A clinocopathologic classification. J Am Acad Dermatol 1993;28:97.  Back to cited text no. 4    


    Figures

[Figure - 1], [Figure - 2], [Figure - 3]

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