Anthroponotic Cutaneous Leishmaniasis (ACL) in Children - Abstract
Cutaneous leishmaniasis is the most common type of old world leishmaniasis which is caused by leishmaniatropica (ACL) and leishmania major (ZCL). Pediatric livings in endemic areas of leishmaniasis are most vulnerable to the infection because of absence of immunity against the parasite and early exposure to the infection. Previous studies have been demonstrated that 60-70% of CL cases have age of under 19 years old. Lesions in pediatric are mostly located in head and neck area and can be misdiagnosed as bite reaction, impetigo and foreign body granuloma. The most common diagnostic method for leishmaniasis in children is slit skin smear. Pathological features of leishmaniasis is depends on parasite species, load of inoculation, duration of the lesion and host immune response. In acute CL diffuse infiltration of histocytes and lymphocytes with few plasma cells is seen. In chronic CL granulomatous infiltration of epithelioid histocytes with lymphocytes and plasma cells is observed in superficial and deep dermis. In pediatric, first-line of treatment is intralesional pentavalent antimonial. Nowadays, oral and topical formulations such as niosomal topical zinc sulphate, topical paromomycin, oral terbinafin is prescribed increasingly, because of absence of pain and acceptable efficacy