title: Leishmaniasis with oral mucosa involvement.
abstract: BACKGROUND
  The term leishmaniasis comprises a group of diseases caused by different protozoan species of the genus Leishmania. There are three main clinical forms of leishmaniasis: visceral, cutaneous and mucocutaneous. Exclusive involvement of the mucosa is very rare.
  
  
  OBJECTIVE
  To present a case of mucocutaneous leishmaniasis in an elderly patient, discuss the clinical presentation, diagnostic process and treatment emphasizing the distinctions from other granulomatous lesions.
  
  
  METHODS
  A 71-year-old male presenting with a symptomatic lesion on the hard and soft palate, which had developed over a period of 6 months was evaluated. The oral exam revealed a lesion with multiple ulcerated nodules on the hard and soft palate extending to the oropharynx. The diagnostic hypothesis was chronic infectious disease (paracoccidioidomycose, tuberculosis and leishmaniasis) or squamous cell carcinoma. Histopathological, histochemical and immunohistochemical analysis were performed. A chest x-ray revealed a normal pulmonary pattern. The Montenegro skin test was positive. The definitive diagnosis was leishmaniasis with exclusive oral manifestation and the patient was treated with liposomal amphotericin.
  
  
  CONCLUSIONS
  Localized oral mucosa leishmaniasis is an uncommon event in an immunocompetent patient. Dentists play an important role in the diagnosis of oral leishmaniasis, which has systemic repercussions.
authors.affiliation: Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Santana, Porto Alegre, Brazil.
authors.forename: Ana C A
authors.initials: AC
authors.lastname: Pellicioli
authors.forename: Marco A T
authors.initials: MA
authors.lastname: Martins
authors.forename: Manoel
authors.initials: M
authors.lastname: Sant'ana Filho
authors.forename: Pantelis V
authors.initials: PV
authors.lastname: Rados
authors.forename: Manoela D
authors.initials: MD
authors.lastname: Martins
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007896:Leishmaniasis / Q000175:diagnosis*; D008297:Male; D009059:Mouth Diseases / Q000382:microbiology / Q000469:parasitology*; D009062:Mouth Neoplasms / Q000175:diagnosis; D019226:Oral Ulcer / Q000469:parasitology; D021362:Palate, Hard / Q000469:parasitology; D010160:Palate, Soft / Q000469:parasitology; D010229:Paracoccidioidomycosis / Q000175:diagnosis; D014393:Tuberculosis, Oral / Q000175:diagnosis
chemical_list: D000981:Antiprotozoal Agents; D000666:Amphotericin B