Leishmania tropica in children: a retrospective study.
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.


CONCLUSIONS
This was a retrospective study.


CONCLUSIONS
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.
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.
Michal
M
Solomon
Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eli
E
Schwartz
Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Felix
F
Pavlotsky
Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Nicole
N
Sakka
Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Aviv
A
Barzilai
Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Shoshana
S
Greenberger
D000279:Administration, Cutaneous; D061605:Administration, Intravenous; D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects; D000967:Antimony Sodium Gluconate / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D017679:Cryotherapy; D005148:Facial Dermatoses / Q000188:drug therapy* / Q000469:parasitology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D007895:Leishmania tropica; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000469:parasitology / Q000628:therapy; D008297:Male; D010303:Paromomycin / Q000008:administration & dosage; D012189:Retrospective Studies; D014344:Trypanocidal Agents / Q000008:administration & dosage* / Q000009:adverse effects
D014344:Trypanocidal Agents; C068538:liposomal amphotericin B; D010303:Paromomycin; D000666:Amphotericin B; D000967:Antimony Sodium Gluconate
Leishmania tropica; children; cryotherapy; intralesional; liposomal amphotericin B; paromomycin ointment; sodium stibogluconate