Leishmaniasis mucosa y otras lesiones destructivas centrofaciales

Abstract

Various illnesses produce lesions in the central facial area. One of the most frequently encountered in our environment is mucotaneous leishmaniasis. As the INS is a centre for the study of mucotaneous leishmaniasis, patients or their biopsies are seen with diseases relating to the greater facial area, being remitted primarily with a diagnosis of mucotaneous leishmaniasis. In a period of 7 years (1 987-1993), 134 biopsies taken from these patients were studied. The mucotaneous leishmaniasis diagnosis was confirmed in 26 cases by staining with hematoxylin-eosin to reveal the presence of amastigotes and the same diagnosis was suggested solely by histopathology in another 27 cases. An immunoenzyme technique to show amastigote presence proved to be unsatisfactory. Commonplace perforation of the septum (52 biopsies) is most frequently confused by the physician and the pathologist as being mucotaneous leishmaniais. Other entities which were revealed were paracoccidioidomicosis (3), histoplasmosis (2), rhinosporidiosis 2), sporotricosis (l), bucal tuberculosis (3), lepra lepromatosa (l), nasal scleroma (2), Wegner's granulomatosis (2), angiocentric linfoma (4), chronic cocaine sniffing (1) and scamocelular carcinoma of the palate (1). Following clinical history, biopsy is the most essential element in adequately identifying and treating these lesions which can cause serious facial damage, sometimes proving lethal if no precise diagnosis or treatment is available at the right time.