唇部黏膜利什曼病:一例青年患者的丰富病例报告。
Mucosal Leishmaniasis of the lip: Report of an Exuberant case in a Young man.
机构信息
Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Stomatology, A.C.Camargo Cancer Center, São Paulo, Brazil.
出版信息
Head Neck Pathol. 2023 Jun;17(2):540-545. doi: 10.1007/s12105-022-01497-8. Epub 2022 Nov 8.
BACKGROUND
Leishmaniasis is a tropical disease caused by protozoan parasites of the genus Leishmania. Mucosal leishmaniasis has been described as secondary to the cutaneous form; however, isolated mucosal involvement can also occur. Specifically, mucosal leishmaniasis of the lip is poorly described and its diagnosis challenges clinicians.
METHODS
We herein report a case of mucosal leishmaniasis affecting the lower lip without cutaneous involvement in a 20-year-old Venezuelan man. The patient had no relevant past medical history. Clinically, a mass-like lesion with ulcerations and crusts was observed.
RESULTS
Microscopically, the lesion was composed of granulomatous inflammation along with macrophages containing intracytoplasmic inclusions similar to round-shaped Leishmania. The species Leishmania (Viannia) braziliensis was confirmed. Treatment with meglumine antimonate was effective. The lesion healed satisfactorily, and no side effects or recurrences were observed.
CONCLUSION
Clinicians should be aware of isolated forms of mucosal leishmaniasis of the lip, even in cases where the cutaneous lesion is undetected or clinically manifests as self-limiting. Knowing the endemic areas in the scenario of the dynamics of the ecoepidemiology of leishmaniasis is also essential for surveillance and counselling of the population.
背景
利什曼病是一种由利什曼原虫属的原生动物寄生虫引起的热带疾病。黏膜利什曼病已被描述为皮肤形式的继发形式;然而,也可能单独发生黏膜受累。具体来说,唇部黏膜利什曼病描述甚少,其诊断对临床医生构成挑战。
方法
我们在此报告一例 20 岁委内瑞拉男性患者的下唇黏膜利什曼病,无皮肤受累。患者无相关既往病史。临床上观察到一个肿块样病变,伴有溃疡和结痂。
结果
显微镜下,病变由肉芽肿性炎症组成,巨噬细胞内含有类似圆形利什曼原虫的胞内内含物。确认物种为利什曼(Viannia)巴西利什曼原虫。采用葡甲胺锑治疗有效。病变愈合满意,无不良反应或复发。
结论
临床医生应注意孤立性唇部黏膜利什曼病,即使皮肤病变未检测到或临床表现为自限性。了解利什曼病生态流行病学动态中的流行地区对于监测和向人群提供咨询也很重要。