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Author Burden-Teh, E. ♦ Wootton, C. I. ♦ Williams, H. C.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Wiley-Blackwell (on behalf of British Association of Dermatologists)
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Parasitic Diseases ♦ Diseases ♦ Organic Chemicals ♦ Carbohydrates ♦ Chemical Actions and Uses ♦ Chemicals and Drugs ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons
Subject Keyword Discipline Dermatology ♦ Ambulatory Care ♦ Methods ♦ Antiprotozoal Agents ♦ Administration & Dosage ♦ Leishmaniasis, Cutaneous ♦ Drug Therapy ♦ Administration, Cutaneous ♦ Aminoglycosides ♦ Child, Preschool ♦ Humans ♦ Male ♦ Paromomycin ♦ Phosphorylcholine ♦ Analogs & Derivatives ♦ Randomized Controlled Trials As Topic ♦ Case Reports ♦ Journal Article ♦ Review
Abstract A 5-year-old boy from rural Afghanistan presented with a 1-year history of a skin lesion on his left knee, confirmed by polymerase chain reaction to be cutaneous leishmaniasis (Leishmania tropica). Conventional treatment of cutaneous leishmaniasis involves intravenous or intralesional pentavalent antimonials. The aim of this Critically Appraised Topic (CAT) is therefore to determine what alternative effective but less painful treatments (such as oral or topical therapies) can be used to treat cutaneous leishmaniasis in children. Embase and PubMed were searched for 'cutaneous leishmania*' AND 'treatment' AND 'children' in August 2014. All abstracts from April 2008 to August 2014 were reviewed. This search period was chosen to follow on from the Cochrane reviews on Old World and American leishmaniasis. Five randomized controlled trials met our inclusion criteria and have been included in this CAT. The study design and reporting quality in most of the trials included in both Cochrane reviews was found to be poor, and neither Cochrane review investigated the effect of patient age on response to treatment. This CAT identified two nonpainful treatments, topical paromomycin and oral miltefosine, whose effective use in children is supported in the literature. However, both of these treatments are currently unlicensed in the U.K. Our patient was successfully treated with miltefosine 20 mg twice daily for 4 weeks, leading to good resolution of the leishmaniasis plaque but with residual scarring.
Description Country affiliation: United kingdom
Author Affiliation: Burden-Teh E ( Department of Dermatology, Nottingham University Hospitals Trust, Nottingham, U.K)
ISSN 00070963
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article ♦ Case study
Publisher Date 2015-04-01
Publisher Place Great Britain (UK)
e-ISSN 13652133
Journal British Journal of Dermatology
Volume Number 172
Issue Number 4


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Source: WHO-Global Index Medicus