title: Mucosal leishmaniasis with primary oral involvement: a case series and a review of the literature.
abstract: OBJECTIVE
  To analyze retrospectively a case series of primary oral leishmaniasis and to review the literature on head-neck primary mucosal leishmaniasis (ML) in immunocompetent patients.
  
  
  METHODS
  A PUBMED search was carried out from 1950 to 2013. Clinical records of patients with primary head-neck mucosal manifestations of leishmaniasis were analyzed. In addition, clinical records between 2001 and 2012 of patients with primary oral manifestations were collected in two independent hospitals.
  
  
  RESULTS
  Our multicenter case series revealed seven patients with oral leishmaniasis. The most commonly affected site was the tongue (four patients, 57%), and the most common clinical presentation was an exophytic lesion (six patients, 85%). The literature review showed 11 reports published between 2005 and 2013, describing 13 patients (100% male) affected by head-neck primary ML (54% laryngeal, 31% oral, 23% pharyngeal, and 15% endonasal). The most common clinical presentation was an exophytic lesion (69%).
  
  
  CONCLUSIONS
  The literature analysis revealed that in immunocompetent patients, the oral mucosa is the second most frequently affected site of the head and neck region. In the oral cavity, the tongue is the most affected site. Diagnosis of oral leishmaniasis represents a challenge but must be considered in any differential diagnosis of exophytic lesions of oral mucosa.
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy.
authors.forename: M D
authors.initials: MD
authors.lastname: Mignogna
authors.forename: A
authors.initials: A
authors.lastname: Celentano
authors.forename: S
authors.initials: S
authors.lastname: Leuci
authors.forename: M
authors.initials: M
authors.lastname: Cascone
authors.forename: D
authors.initials: D
authors.lastname: Adamo
authors.forename: E
authors.initials: E
authors.lastname: Ruoppo
authors.forename: G
authors.initials: G
authors.lastname: Favia
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007558:Italy; D007891:Leishmania; D007897:Leishmaniasis, Mucocutaneous / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis / Q000469:parasitology* / Q000473:pathology
keywords: head-neck leishmaniasis; immunocompetent; mucosal; primary oral leishmaniasis