Mucocutaneous leishmaniasis with upper airway involvement: A report of three cases.

Abstract

Mucocutaneous leishmaniasis (MCL) is a rare and challenging clinical presentation of tegumentary leishmaniasis, primarily affecting the mucosal surfaces of the upper airway. It is often misdiagnosed due to its non-specific symptoms, which can mimic inflammatory, infectious, or neoplastic conditions. This study reports three autochthonous cases of MCL diagnosed between 2023 and 2024. The patients presented chronic symptoms such as dysphagia, odynophagia, lip edema, and ulcerative mucosal lesions. Diagnosis was established through mucosal biopsies, revealing intracellular Leishmania amastigotes via histopathological examination. Treatment varied across the cases and included liposomal Amphotericin B, Meglumine Antimoniate, and Miltefosine, reflecting the complexity of managing MCL. All patients achieved complete clinical remission after individualized therapeutic regimens and careful follow-up. These cases emphasize the importance of considering MCL in the differential diagnosis of persistent upper airway lesions in endemic regions. Early and accurate diagnosis, coupled with tailored treatment strategies, is essential for preventing disease progression and achieving successful clinical outcomes. Furthermore, these findings underscore the need for heightened clinical awareness and multidisciplinary collaboration in managing this rare but significant disease presentation.