Clinical, microscopic and molecular presentation in pediatric versus adult old world cutaneous Leishmaniasis

Pediatr Dermatol. 2020 Jul;37(4):656-660. doi: 10.1111/pde.14195. Epub 2020 May 18.

Abstract

Background: Cutaneous leishmaniasis (CL) is an emerging uncontrolled tropical parasitic disease in endemic and nonendemic areas with a high prevalence in the pediatric age group.

Method: A total of 382 individuals from Lebanon, Saudi Arabia, Pakistan, and Syria diagnosed with CL by punch biopsy/scrapings were grouped into adults (>18 years) and pediatrics (≤18 years). Data recorded included clinical features [number, location, type, size, and extensiveness (size larger than 3 cm, more than 5 lesions per patient, lesion present for more than 12 months, special types, disfiguring lesion or closeness to vital sensory organs) of lesions] and microscopic findings [Ridley's Parasitic Index and Ridley's Pattern]. In addition, molecular confirmation and speciation were performed.

Results: In comparison with adults, patients in the pediatric group (n = 158, 41.4%) showed significantly higher number of lesions, more facial involvement, and more extensive disease (P < .05). Microscopically, a more advanced Ridley's pattern was observed. The other variables did not show statistical difference between the two groups.

Conclusion: Historically, CL has been known to be a neglected tropical disease of poverty and pediatric predilection. In our pediatric group, CL manifests with more extensive disease clinically mirrored by more advanced lesions microscopically.

Keywords: inflammatory disorder; insect bite.

MeSH terms

  • Adult
  • Child
  • Humans
  • Leishmaniasis, Cutaneous* / diagnosis
  • Leishmaniasis, Cutaneous* / epidemiology
  • Neglected Diseases / diagnosis
  • Neglected Diseases / epidemiology
  • Pediatrics*
  • Saudi Arabia
  • Skin