title: Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.
abstract: Cutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking.
  
  
  
  In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6-10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0-5 year and 11-15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0-5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0-5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0-5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6-15 years old.
  
  
  
  We report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0-5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to intralesional treatment and highlighting the need for more effective therapeutic strategies against CL.
authors.affiliation: Department of Dermatology, Harran University School of Medicine, Sanliurfa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aksoy
authors.affiliation: Department of Microbiology, Harran University School of Medicine, Sanliurfa, Turkey.
authors.forename: Nebiye
authors.initials: N
authors.lastname: Doni
authors.affiliation: Department of Dermatology, Yuzuncu Yıl University School of Medicine, Van, Turkey.
authors.forename: Hatice Uce
authors.initials: HU
authors.lastname: Ozkul
authors.affiliation: Ministry of Health, Health Sciences University, Van Training and Research Hospital, Dermatology Clinic, Van, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Yesilova
authors.affiliation: Department of Microbiology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Nurittin
authors.initials: N
authors.lastname: Ardic
authors.affiliation: Department of Biostatistics, Yuzuncu Yıl University School of Medicine, Van, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Yesilova
authors.affiliation: Biosciences, College of Dentistry, Ohio State University, Columbus, Ohio, United States of America.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ahn-Jarvis
authors.affiliation: Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, Ohio, United States of America.
authors.forename: Steve
authors.initials: S
authors.lastname: Oghumu
authors.affiliation: Department of Pathology, Ohio State University Medical Center, Columbus, Ohio, United States of America.
authors.forename: Cesar
authors.initials: C
authors.lastname: Terrazas
authors.affiliation: Department of Pathology, Ohio State University Medical Center, Columbus, Ohio, United States of America.
authors.forename: Abhay R
authors.initials: AR
authors.lastname: Satoskar
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology