LEISHMANIASIS IN NASAL AND ORAL MUCOSA

Objective: Considering the rarity of leishmaniasis affecting the upper aerodigestive tract mucosa and the difficulty in making such a diagnosis when the parasites are scarce in tissue samples, the objective was to analyze the microscopic, histologic, and molecular aspects of mucocutaneous leishmaniasis (MCL) and mucosal leishmaniasis (ML) in this anatomic region. Study design: We analyzed the histochemical, immunohistochemical, and molecular features in 17 cases of leishmaniasis. Results: Mucosal disease was principally found in the soft palate, oropharynx, and nose, manifesting mainly as a solitary ulcer. In hematoxylin-eosin–stained sections, 10 cases revealed abundant amastigotes within the macrophages. Giemsa staining did not prove to be helpful in confirming the diagnosis in 6 cases with scarce or nondetectable amastigotes. Immunohistochemistry (IHC) showed high sensitivity by positive staining in 14 out 17 cases (82.3%). Polymerase chain reaction (PCR) was more sensitive than IHC with 13 out 14 (92.8%) positive cases, including the 3 IHC negative cases; however, this technique is not available in many endemic regions. Conclusion: Leishmaniasis should be considered in the presence of ulcerated lesions on the oral mucosa. IHC is a simple technique with rapid results and is a helpful tool that should be implemented in the routine diagnosis of leishmaniasis. FAPEMIG APQ01122/14