Cutaneous leishmaniasis
ICD-10 B55.1 · ICD-11 1F54.1

Cutaneous Leishmaniasis in Children Under 18: Next-Step Treatment After Initial Management Did Not Achieve Healing

This protocol addresses patients under 18 years of age with cutaneous leishmaniasis in whom the initial conservative approach — observation or local cryotherapy for small nodular lesions — has not resulted in complete healing of the lesion, or in whom the lesion pattern indicates a more active treatment is needed.

Why Initial Treatment Was Insufficient

The preceding approach for small nodular lesions — leaving them alone (no treatment) or applying cryotherapy only — aimed for complete reepithelialization of the cutaneous lesion. When that goal is not achieved, this protocol provides the next step.

Clinical Scenario

Patient is under 18 years of age with confirmed cutaneous leishmaniasis. Treatment guidelines applicable to adults generally also apply to children, with specific considerations for the paediatric patient.

Treatment Approach (Partial Overview)

For multiple or large lesions in this age group, oral pharmacological therapy is among the approaches considered — including options such as fluconazole. Full treatment selection, clinical criteria, and dosing details are available in the structured protocol.

Treatment Goal

Complete reepithelialization (healing) of the cutaneous lesion.

Instant Access to Structured Evidence-Based Regimens

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).

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