{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:16:59Z","timestamp":1776921419722,"version":"3.51.2"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T00:00:00Z","timestamp":1402272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mucosal leishmaniasis (<jats:styled-content style=\"fixed-case\">ML<\/jats:styled-content>), which mostly occurs in the New World, is mainly associated with <jats:italic>Leishmania braziliensis<\/jats:italic>. Primary lip <jats:styled-content style=\"fixed-case\">ML<\/jats:styled-content> is very rare in the Mediterranean basin and particulary in Tunisia despite the endemicity of both cutaneous and visceral leishmaniasis in this area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To highlight a recent emergence of primary lip <jats:styled-content style=\"fixed-case\">ML<\/jats:styled-content> in Tunisia, to describe its epidemiological and clinical features and to identify the causative <jats:italic>Leishmania<\/jats:italic> species.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Epidemiological, clinical and therapeutic data of 10 cases presenting a <jats:styled-content style=\"fixed-case\">ML<\/jats:styled-content> of the lip were collected. Diagnosis confirmation of leishmaniasis was obtained by microscopic examination of <jats:italic>Leishmania parasites<\/jats:italic> in Giemsa stained smears of the lesion sampling and in cutaneous biopsies. Polymerase chain reaction (<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>) detecting <jats:italic>Leishmania <\/jats:italic><jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> directly from dermal scraping was also performed for diagnosis and species identification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven men and three women with lip <jats:styled-content style=\"fixed-case\">ML<\/jats:styled-content> were diagnosed during the last 6\u00a0years (2008\u20102013). The mean age was 29.7\u00a0years. Clinical presentation was characterized by an infiltrated and ulcerated plaque leading to macrocheilitis involving the upper lip in eight cases and the lower lip in two cases. Mean diagnosis delay was 6.9\u00a0months. <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> identified <jats:italic>L. infantum<\/jats:italic> in seven cases and <jats:italic>L. major<\/jats:italic> in two cases. Seven patients received intramuscular injections of meglumine antimoniate (<jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content>) and three patients received both <jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content> intralesional injections of <jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content> and cryotherapy. A clinical remission was rapidly observed in all cases (on average in 2.2\u00a0months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Primary lip <jats:styled-content style=\"fixed-case\">ML<\/jats:styled-content> is emerging in Tunisia. Macrocheilitis of the upper lip is the main clinical presentation. <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> revealed more sensitive than direct examination in the diagnosis of such form (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). <jats:italic>Leishmania infantum<\/jats:italic> was the most identified species (7 cases) while <jats:italic>L major<\/jats:italic> was involved in only two lesions. A benign local evolution and a rapid recovery were observed in all cases after <jats:styled-content style=\"fixed-case\">MA<\/jats:styled-content> treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12580","type":"journal-article","created":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T11:06:43Z","timestamp":1402312003000},"page":"1212-1215","source":"Crossref","is-referenced-by-count":16,"title":["Mucosal leishmaniasis of the lip: an emerging clinical form in Tunisia"],"prefix":"10.1111","volume":"29","author":[{"given":"H.","family":"Hammami\u2010Ghorbel","sequence":"first","affiliation":[{"name":"Department of Dermatology Habib Thameur Hospital Tunis Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Ben Abda","sequence":"additional","affiliation":[{"name":"Research Lab \u201cParasitoses m\u00e9dicales, Biotechnologie &amp; Biomol\u00e9cules\u201d LR 11 IPT 06 Pasteur Institute of Tunis Tunis Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Badri","sequence":"additional","affiliation":[{"name":"Department of Dermatology Habib Thameur Hospital Tunis Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Chelbi","sequence":"additional","affiliation":[{"name":"Research Lab \u201cParasitoses m\u00e9dicales, Biotechnologie &amp; 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