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Leishmania tropica in children: a retrospective study.
J Am Acad Dermatol. 2014 Aug; 71(2):271-7.JA

Abstract

BACKGROUND

Limited data are available regarding topical and systemic therapies for Leishmania tropica in children.

OBJECTIVE

We sought to characterize the clinical presentation and evaluate the efficacy and safety of topical and systemic treatments in pediatric patients infected with L tropica.

METHODS

A retrospective study was performed on 47 children with L tropica cutaneous leishmaniasis. Treatments included topical or systemic therapy with liposomal amphotericin B or pentavalent antimony.

RESULTS

Seventy patients with L tropica cutaneous leishmaniasis were treated at our center between 2008 and 2012, of which 47 (67%) were children. The average age of the pediatric population was 8.8 years, and the face was the most common site of involvement (76%). The average number of lesions was 2.6. 24 children (51%) required systemic therapy. The patients were treated with 3 to 5 mg/kg/d of intravenous liposomal amphotericin B, and a response was observed in 83% of the patients within 3 months.

LIMITATIONS

This was a retrospective study.

CONCLUSION

The disease burden of L tropica in children is high, and because of facial involvement and a low response to topical therapies, systemic therapy is often required. In our experience, liposomal amphotericin B treatment in children is safe and effective and is required for a considerably shorter duration than treatment with pentavalent antimony.

Authors+Show Affiliations

Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: solomondr1@gmail.com.Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel.Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24775403

Citation

Solomon, Michal, et al. "Leishmania Tropica in Children: a Retrospective Study." Journal of the American Academy of Dermatology, vol. 71, no. 2, 2014, pp. 271-7.
Solomon M, Schwartz E, Pavlotsky F, et al. Leishmania tropica in children: a retrospective study. J Am Acad Dermatol. 2014;71(2):271-7.
Solomon, M., Schwartz, E., Pavlotsky, F., Sakka, N., Barzilai, A., & Greenberger, S. (2014). Leishmania tropica in children: a retrospective study. Journal of the American Academy of Dermatology, 71(2), 271-7. https://doi.org/10.1016/j.jaad.2013.12.047
Solomon M, et al. Leishmania Tropica in Children: a Retrospective Study. J Am Acad Dermatol. 2014;71(2):271-7. PubMed PMID: 24775403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Leishmania tropica in children: a retrospective study. AU - Solomon,Michal, AU - Schwartz,Eli, AU - Pavlotsky,Felix, AU - Sakka,Nicole, AU - Barzilai,Aviv, AU - Greenberger,Shoshana, Y1 - 2014/04/26/ PY - 2013/05/20/received PY - 2013/12/17/revised PY - 2013/12/23/accepted PY - 2014/4/30/entrez PY - 2014/4/30/pubmed PY - 2014/9/17/medline KW - Leishmania tropica KW - children KW - cryotherapy KW - intralesional KW - liposomal amphotericin B KW - paromomycin ointment KW - sodium stibogluconate SP - 271 EP - 7 JF - Journal of the American Academy of Dermatology JO - J Am Acad Dermatol VL - 71 IS - 2 N2 - BACKGROUND: Limited data are available regarding topical and systemic therapies for Leishmania tropica in children. OBJECTIVE: We sought to characterize the clinical presentation and evaluate the efficacy and safety of topical and systemic treatments in pediatric patients infected with L tropica. METHODS: A retrospective study was performed on 47 children with L tropica cutaneous leishmaniasis. Treatments included topical or systemic therapy with liposomal amphotericin B or pentavalent antimony. RESULTS: Seventy patients with L tropica cutaneous leishmaniasis were treated at our center between 2008 and 2012, of which 47 (67%) were children. The average age of the pediatric population was 8.8 years, and the face was the most common site of involvement (76%). The average number of lesions was 2.6. 24 children (51%) required systemic therapy. The patients were treated with 3 to 5 mg/kg/d of intravenous liposomal amphotericin B, and a response was observed in 83% of the patients within 3 months. LIMITATIONS: This was a retrospective study. CONCLUSION: The disease burden of L tropica in children is high, and because of facial involvement and a low response to topical therapies, systemic therapy is often required. In our experience, liposomal amphotericin B treatment in children is safe and effective and is required for a considerably shorter duration than treatment with pentavalent antimony. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/24775403/Leishmania_tropica_in_children:_a_retrospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(14)01238-9 DB - PRIME DP - Unbound Medicine ER -