Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Am Acad Dermatol. 2014 Aug;71(2):271-7. doi: 10.1016/j.jaad.2013.12.047. Epub 2014 Apr 26.
Limited data are available regarding topical and systemic therapies for Leishmania tropica in children.
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.
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.
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.
This was a retrospective study.
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.
有关儿童利什曼原虫的局部和全身治疗的数据有限。
我们旨在描述儿童利什曼原虫感染患者的临床表现，并评估局部和全身治疗的疗效和安全性。
对 47 例患有利什曼原虫皮肤利什曼病的儿童进行了回顾性研究。治疗包括使用脂质体两性霉素 B 或五价锑进行局部或全身治疗。
2008 年至 2012 年期间，我们中心共治疗了 70 例利什曼原虫皮肤利什曼病患者，其中 47 例（67%）为儿童。儿科人群的平均年龄为 8.8 岁，面部是最常见的受累部位（76%）。平均病变数为 2.6。24 例（51%）患儿需要全身治疗。这些患者接受了 3 至 5mg/kg/d 的静脉注射脂质体两性霉素 B 治疗，其中 83%的患者在 3 个月内出现了应答。
这是一项回顾性研究。
儿童利什曼原虫的疾病负担很高，由于面部受累和局部治疗反应不佳，通常需要全身治疗。根据我们的经验，儿童使用脂质体两性霉素 B 治疗安全有效，所需治疗时间明显短于五价锑治疗。
