Primary Lip Leishmaniasis-Report of 4 Cases from a Non-endemic Region of Kashmir Valley of North India and Review of Literature

Abstract

Leishmaniasis is a disease caused by an intracellular protozoan parasite of the genus Leishmania and transmitted by the bite of a female sandfly(phlebotomus). The clinical spectrum of leishmaniasis ranges from a self-resolving cutaneous ulcer to a mutilating mucocutaneous disease and even to a lethal systemic illness. Therapy has long been a challenge in the more severe forms of the disease, and it is made more difficult by the emergence of drug resistance.Cutaneous leishmaniasis is a common tropical dermatoses with diverse clinical presentations. At times, it may appear in an unusual shape or at an unusual site and thus cause a diagnostic challenge. Primary lip mucosal leishmaniasis (ML) is now a common presentation from non- endemic areas, and is commonly being encountered in old world/non-endemic areas now. Lip leishmaniasis, as cutaneous type of leishmaniasis not as part of mucocutaneous type, has been infrequently mentioned in the medical literature [1,2]. A few cases of leishmaniasis of lip have been described in literature. The description of cases of leishmaniasis solely involving the lip from India is rare [3]. We hereby describe four cases of lip leishmaniasis from Kashmir, a non-endemic area for the disease who were successfully treated with sodium stibogluconate (SSG).