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Several disorders may produce a destructive ulcerative lesion of the midface and nasal cavity known as lethal midline granuloma. We wish to underline that this descriptive designation implies careful investigations for not only bacterial, fungal or neoplastic, but also for parasitic causes before the diagnosis of lethal midline granuloma can be accepted.1 We report here the unusual observation of a chronic midface ulcerative and necrotizing lesion due to a Leishmania species contracted in Djibouti. Mucocutaneous leishmaniasis is very rarely encountered in the Old World and difficulties in isolating: the organism may benefit from new sampling and leishmaniasis culture techniques.2
Farge et al. (1987) studied this question.