Cutaneous Leishmaniasis Treatment in Children and Adolescents Under 18

General guidelines for cutaneous leishmaniasis apply to paediatric patients, but age introduces specific clinical constraints that shape which management options are appropriate.

Clinical Scenario

This protocol addresses cutaneous leishmaniasis in patients under 18 years of age. While the broader adult guidelines serve as the framework, paediatric cases — particularly in younger children — require age-sensitive judgement regarding which interventions can be safely used.

Treatment Approach (partial)

For small nodular lesions in this age group, conservative management is a recognised option — including watchful waiting or localised cryotherapy. The complete protocol details the criteria and additional management pathways that apply when lesions do not meet this profile.

Clinical Goal

Complete reepithelialization (full healing) of the cutaneous lesion. Treatment failure is defined as incomplete reepithelialization at 3 months after starting therapy.

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References

DOI: 10.1111/jtm.12089

In general, the guidelines above also apply to children.
One is reluctant to do infiltrations on the faces of children younger than 7 years.
Small nodular lesions may be left alone or treated with cryotherapy only and multiple or large lesions can be treated with fluconazole or with miltefosine (2.5–3 mg/kg).
Treatment failure is present when reepithelialization is incomplete 3 months after starting therapy.

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