Clinical Spectrum of Cutaneous Leishmaniasis in Children of Southern Region of Pakistan

Abstract

Background: Cutaneous leishmaniasis (CL) has a wide spectrum of clinical presentations. Children are not considered as vulnerable as adults to acquire the disease and studies regarding clinical spectrum of CL in children population are sparse. Objective: The study was aimed to explore the extended clinical spectrum of CL in children of southern region of Pakistan. Methods: Children of all ages having lesions clinically suggestive of CL, anywhere on the body were included in the study (Jan 2019-Dec 2023).The diagnosis was established on the basis of clinical appearance, geographical origin and slit skin smear examination. Patients were treated with weekly intralesional injections of meglumine antimonite for 4-16 weeks. Various demographical features and clinical patterns were recorded. Descriptive statistics were used for analysis. Results: 72 childhood cases were seen among 316 of total patients of cutaneous leishmaniasis. Age range was 3 months -15 years (mean age = 8.72 + 4.47). Male to female ratio was 1.5:1.Majority of the patients (75%) had solitary lesions. Maximum lesion count was >50 in one case and 90%had lesions on face. Cheeks were most common sites followed by nose and lips. Predominant clinical pattern was psoriasiform plaque followed by nodular, noduloulcerative. Some atypical morphologies like furunculoid, cheilitis, chancriform, verroucous and lupoid were also seen. All patients responded well to treatment without any significant side effect. Conclusion: Childhood CL exhibits varied clinical spectrum. Lesions are characteristically seen on face as against on extremities in adults and respond favorably to weekly intralesional treatment with antimonial compound.