Cutaneous Leishmaniasis in Children Under 18 When Cryotherapy Has Not Achieved Healing
This protocol applies to pediatric patients under 18 years of age with cutaneous leishmaniasis in whom the initial treatment approach has not produced complete lesion healing.
Patient Population
Children under 18 years of age with cutaneous leishmaniasis. In general, the treatment guidelines that apply to adults also apply to children, though there is reluctance to perform certain procedures on very young children.
Prior Treatment & Failure Condition
The preceding step for small nodular lesions — observation alone or cryotherapy — did not achieve the treatment goal of complete reepithelialization (healing) of the cutaneous lesion. This protocol is the structured next step when that goal remains unmet.
Next-Line Treatment Approach
For multiple or large lesions, or when initial management has not achieved healing, an oral pharmacological therapy is among the approaches indicated. The complete evidence-based regimen — specific agents, selection criteria, and full treatment pathway — is available in the structured protocol below.
Treatment Goal
Complete reepithelialization (healing) of the cutaneous lesion.
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.
View source ↗