Pediatrik Kutanöz Leishmania Olgularının Değerlendirilmesi
Yıl 2023,
Cilt: 45 Sayı: 6, 902 - 908, 24.10.2023
Merve İşeri Nepesov
,
Yalçın Kara
,
Mahmut Can Kızıl
,
Hilal Kaya Erdoğan
,
Kursat Bora Carman
,
Nihal Doğan
,
Tercan Us
,
Ömer Kılıç
,
Ener Çağrı Dinleyici
Öz
Kutanöz Leishmaniasis (KL), enfekte dişi tatarcık sineğinin ısırması ile bulaşan ve ülsere nodüler lezyonlarla karakterize, leishmania tipi protozoanların neden olduğu bir hastalık olup, dünyanın bazı bölgelerinde endemik olarak görülmektedir. Çalışmaya çocuk enfeksiyon hastalıkları ve dermatoloji tarafından takip edilen 21 pediatrik kutanöz leishmania olgusu dahil edildi. Hastaların demografik ve klinik özellikleri, aldıkları lokal veya sistemik tedaviler ve yan etkileri retrospektif olarak incelendi. Olguların 14'ü (%66) kız, 7'si (%34) erkekti. Olguların ortalama yaşı 6.4 yıldı. Hastaların 15'i mülteciydi (hastalardan yedisi Iraklı, sekizi Suriye'liydi). Hastaların 10'unda (%47) sadece yüzde, 6'sında (%28) hem yüzde hem de elde, 4'ünde (%20) alt ekstremitede lezyon vardı. Yedi hastada (%34) tek lezyon, ondördünde çoklu lezyon ve yedi hastada dörtten fazla lezyon vardı. 13 hastanın direk mikroskopik incelemesinde amastigot gözlendi. 15 hastaya intralezyonel tedavi, 6 hastaya sistemik tedavi verildi, 2 hasta sistemik tedaviyi reddetti. Beş hastaya meglumin antimoniat, bir hastaya amfoterisin B verildi. Bir hastada amfoterisin b sonrası yüzde şişlik, kızarıklık ve ödem gibi yan etkiler gelişti ve tedavi meglumin antimoniat olarak değiştirildi. Kutanöz Leishmaniasis, leishmania cinsi protozoalarının neden olduğu kronik bir hastalıktır. Uluslararası seyahat, göç ve mülteciler nedeniyle sadece endemik bölgeler değil, tüm dünyada nispeten yaygın bir durum haline gelmiştir. Endemik bölgelerin dışında kronik, ağrısız cilt lezyonları olduğunda Kutanöz Leishmania düşünülmelidir
Kaynakça
- 1. David CV, Craft N. Cutaneous and mucocutaneous leishmaniasis. Dermatol Ther 2009;22:491-502.
- 2. WHO Technical Report Series, 949; Control of the Leishmaniases: Report of a Meeting of the WHO Expert Committee on the Control of Leishmaniases. 2010.
- 3. Gürel MS, Yeşilova Y, Olgen MK, et al. Cutaneous leishmaniasis in Turkey. Turkiye Parazitol Derg 2012; 36: 121-9.
- 4. Harman M. Kutanöz Leishmaniasis. Turk J Dermatol 2015;168-76 .
- 5. Burza S, Croft SL, Boelaert M. Leishmaniasis. Lancet 2010;392: 951–70.
- 6. Cattand P, Desjeux P, Guzman MG et al. Disease Control Priorities in Developing Countries 2016. 2nd edition. Washington. Chapter 23, Tropical DiseasesLacking Adequate Control Measures: Dengue, Leishmaniasis, and African Trypanosomiasis.
- 7. Durdu M, Baba M, Seçkin D. More experiences with the Tzanck smear test: cytologic findings in cutaneous granulomatous disorders. J Am Acad Dermatol 2009;61:441-50.
- 8. Freitas-Junior LH, Chatelain E, Kim HA, et al. Visceral leishmaniasis treatment: What do we have, what do we need, and how to deliver it? Int J Parasitol Drugs Drug Resist 2012;2: 11-19.
- 9. Sharara SL, Kanj SS. War and infectious diseases: challenges of the Syrian civil war. PLoS Pathog 2014; 10: e1004438.
- 10. Kaman A, Tanır G, Gayretli Aydın ZG, et al. Cutaneous Leishmaniasis in Pediatric Patients in a Single Tertiary Hospital in Ankara. Turkiye Parazitol Derg. 2017 Dec;41(4):214-218.
- 11. Kaya OM, Serarslan G, Dirican E. Evaluation of clinical and demographic characteristics of Turkish and Syrian pediatric cutaneous leishmaniasis patients from Hatay, Turkey after the Syrian civil war. Postepy Dermatol Alergol. 2020 Apr;37(2):229-233.
- 12. Aissaoui N, Hamane S, Gits-Muselli M,et al. Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France. BMC Infect Dis. 2021 Sep 15;21(1):953.
- 13. Cömert-Aksu M, Denız S, Togay M, et al. Epidemiological evaluation of the patients diagnosed with cutaneous leishmaniasis during the period of 2010-2015 in Mersin province Turk Hij Den Biyol Derg, 77(2): 139-148.
- 14. Kireççi E, Öztürk P, Güler S et al. Kahramanmaraş ilinde 2011-2013 yılları arasında tanı konan kutanöz leyişmanyoz olgularının retrospektif olarak değerlendirilmesi. Mersin Ünv Sağlık Bilim Derg 2013; 6(2).
- 15. Agrawal S, Khandelwal K, Bumb RA, et al. Short report: pediatric cutaneous leishmaniasis in an endemic region in India. Am J Trop Med Hyg 2014; 91: 901-4.
- 16. Sharifi I, Fekri AR, Aflatonian MR, et al. Cutaneous leishmaniasis in primary school children in the south-eastern Iranian city of Bam, 1994-95. Bull World Health Organ 1998; 76: 289-93.
- 17. Aksoy M, Doni N, Ozkul HU, et al. Pediatric cutaneous leishmaniasis in an endemic region in Turkey: a retrospective analysis of 8786 cases during 1998-2014. PLoS Negl Trop Dis 2016; 10: e0004835.
- 18. Layegh P, Moghiman T, Hoseini SAA. Children and cutaneous leishmaniasis: a clinical report and review. J Infect Dev Ctries 2013; 7: 614-7.
- 19. Bari AU. Childhood cutaneous leishmaniasis. J Clin Diagn Res 2008; 2: 973-8.
- 20. Nguyen AK, Yang K, Bryant K, Li J, Joice AC, Werbovetz KZ, et al. Microneedle-based delivery of amphotericin b for treatment of cutaneous leishmaniasis. Biomedical Microdevices 2019;21:1-10.
- 21. Wijnant GJ, Bocxlaer KV, Francisco AF, Yardley V, Harris A, Alavijeh M, et al. Local skin ınflammation in cutaneous leishmaniasis as a source of variable pharmacokinetics and therapeutic efficacy of liposomal amphotericin B. Antimicrobial Agents Chemotherapy 2018;62:e00631- 18
- 22. Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA. Cutaneous and mucocutaneous leishmaniasis: Differential diagnosis, diagnosis, histopathology and management. J Am Acad Dermatol 2018;73:911- 26.
- 23. Taşkın, Esra Çakmak, et al. "A Case of Cutaneous Leishmaniasis Responding to Systemic Liposomal Amphotericin B Treatment." Journal of Pediatric Infection/Cocuk Enfeksiyon Dergisi 14.4 (2020).
- 24. Altinel Y, Tas B. How to Predict the Diagnosis of Cutaneous Leishmaniasis in a Non-Endemic Region. Indian J Dermatol. 2022 May-Jun;67(3):232-238.
- 25. Nalçacı M, Karakuş M, Özbel Y, Özbilgin A, Töz S. Increasing the Sensitivity of Leishmania RNA Virus 2 (LRV2) Detection with a Modification in cDNA Synthesis. Turkiye Parazitol Derg. 2022 May 23;46(2):86-90. English.
- 26. Gürses G, Yentür Doni N, Yıldız Zeyrek F, Yiğin A. Typing of Leishmania Species Causing Cutaneous Leishmaniasis by Sybr Green Based ITS-1 Real Time Polymerase Chain Reaction Method. Mikrobiyol Bul. 2022 Apr;56(2):326-338.
Evaluation of Pediatric Cutaneous Leishmania Cases
Yıl 2023,
Cilt: 45 Sayı: 6, 902 - 908, 24.10.2023
Merve İşeri Nepesov
,
Yalçın Kara
,
Mahmut Can Kızıl
,
Hilal Kaya Erdoğan
,
Kursat Bora Carman
,
Nihal Doğan
,
Tercan Us
,
Ömer Kılıç
,
Ener Çağrı Dinleyici
Öz
Cutaneous Leishmaniasis (CL) is a disease caused by leishmania-type protozoans, which is transmitted by the bite of infected female phlebotomine sandflies and is characterized by ulcerated nodular lesions. Twenty-one pediatric cutaneous leishmania cases followed by pediatric infectious diseases and dermatology were included in the study. The demographic and clinical characteristics of the patients, the local or systemic treatments, and side effects were analyzed retrospectively. 14 (66%) of the patients were female and 7 (34%) were male. The mean age of the cases was 6.4 years. Fifteen of the patients were refugees (seven of the patients were from Iraq, and eight of them were from Syria). Ten of the patients ( 47%) had lesions only on the face, 6 (28%) were both on the face and hand, 4 (20%) were on the lower extremities. Seven patients (34%) had a single lesion, fourteen had multiple lesions and seven had more than four lesions. Amastigote was observed in the microbiological examination of skin scraping samples of 13 patients. Intralesional therapy was given to 15 patients, systemic treatment was given to 6 patients, and 2 patients refused systemic treatment. Five patient was given meglumine antimoniate, one patient was given amphotericin B. In one patient, side effects such as facial swelling, rash, and edema developed after amphotericin b, and the treatment was changed to meglumine antimoniate. Leishmaniasis is a chronic disease caused by flagellate protozoa of the genus Leishmania. especially in endemic countries. CL has become a relatively common condition all over the world due to international travel, migration, and refugees. Cutaneous Leishmania should be considered when there are chronic, painless skin lesions outside of endemic areas.
Kaynakça
- 1. David CV, Craft N. Cutaneous and mucocutaneous leishmaniasis. Dermatol Ther 2009;22:491-502.
- 2. WHO Technical Report Series, 949; Control of the Leishmaniases: Report of a Meeting of the WHO Expert Committee on the Control of Leishmaniases. 2010.
- 3. Gürel MS, Yeşilova Y, Olgen MK, et al. Cutaneous leishmaniasis in Turkey. Turkiye Parazitol Derg 2012; 36: 121-9.
- 4. Harman M. Kutanöz Leishmaniasis. Turk J Dermatol 2015;168-76 .
- 5. Burza S, Croft SL, Boelaert M. Leishmaniasis. Lancet 2010;392: 951–70.
- 6. Cattand P, Desjeux P, Guzman MG et al. Disease Control Priorities in Developing Countries 2016. 2nd edition. Washington. Chapter 23, Tropical DiseasesLacking Adequate Control Measures: Dengue, Leishmaniasis, and African Trypanosomiasis.
- 7. Durdu M, Baba M, Seçkin D. More experiences with the Tzanck smear test: cytologic findings in cutaneous granulomatous disorders. J Am Acad Dermatol 2009;61:441-50.
- 8. Freitas-Junior LH, Chatelain E, Kim HA, et al. Visceral leishmaniasis treatment: What do we have, what do we need, and how to deliver it? Int J Parasitol Drugs Drug Resist 2012;2: 11-19.
- 9. Sharara SL, Kanj SS. War and infectious diseases: challenges of the Syrian civil war. PLoS Pathog 2014; 10: e1004438.
- 10. Kaman A, Tanır G, Gayretli Aydın ZG, et al. Cutaneous Leishmaniasis in Pediatric Patients in a Single Tertiary Hospital in Ankara. Turkiye Parazitol Derg. 2017 Dec;41(4):214-218.
- 11. Kaya OM, Serarslan G, Dirican E. Evaluation of clinical and demographic characteristics of Turkish and Syrian pediatric cutaneous leishmaniasis patients from Hatay, Turkey after the Syrian civil war. Postepy Dermatol Alergol. 2020 Apr;37(2):229-233.
- 12. Aissaoui N, Hamane S, Gits-Muselli M,et al. Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France. BMC Infect Dis. 2021 Sep 15;21(1):953.
- 13. Cömert-Aksu M, Denız S, Togay M, et al. Epidemiological evaluation of the patients diagnosed with cutaneous leishmaniasis during the period of 2010-2015 in Mersin province Turk Hij Den Biyol Derg, 77(2): 139-148.
- 14. Kireççi E, Öztürk P, Güler S et al. Kahramanmaraş ilinde 2011-2013 yılları arasında tanı konan kutanöz leyişmanyoz olgularının retrospektif olarak değerlendirilmesi. Mersin Ünv Sağlık Bilim Derg 2013; 6(2).
- 15. Agrawal S, Khandelwal K, Bumb RA, et al. Short report: pediatric cutaneous leishmaniasis in an endemic region in India. Am J Trop Med Hyg 2014; 91: 901-4.
- 16. Sharifi I, Fekri AR, Aflatonian MR, et al. Cutaneous leishmaniasis in primary school children in the south-eastern Iranian city of Bam, 1994-95. Bull World Health Organ 1998; 76: 289-93.
- 17. Aksoy M, Doni N, Ozkul HU, et al. Pediatric cutaneous leishmaniasis in an endemic region in Turkey: a retrospective analysis of 8786 cases during 1998-2014. PLoS Negl Trop Dis 2016; 10: e0004835.
- 18. Layegh P, Moghiman T, Hoseini SAA. Children and cutaneous leishmaniasis: a clinical report and review. J Infect Dev Ctries 2013; 7: 614-7.
- 19. Bari AU. Childhood cutaneous leishmaniasis. J Clin Diagn Res 2008; 2: 973-8.
- 20. Nguyen AK, Yang K, Bryant K, Li J, Joice AC, Werbovetz KZ, et al. Microneedle-based delivery of amphotericin b for treatment of cutaneous leishmaniasis. Biomedical Microdevices 2019;21:1-10.
- 21. Wijnant GJ, Bocxlaer KV, Francisco AF, Yardley V, Harris A, Alavijeh M, et al. Local skin ınflammation in cutaneous leishmaniasis as a source of variable pharmacokinetics and therapeutic efficacy of liposomal amphotericin B. Antimicrobial Agents Chemotherapy 2018;62:e00631- 18
- 22. Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA. Cutaneous and mucocutaneous leishmaniasis: Differential diagnosis, diagnosis, histopathology and management. J Am Acad Dermatol 2018;73:911- 26.
- 23. Taşkın, Esra Çakmak, et al. "A Case of Cutaneous Leishmaniasis Responding to Systemic Liposomal Amphotericin B Treatment." Journal of Pediatric Infection/Cocuk Enfeksiyon Dergisi 14.4 (2020).
- 24. Altinel Y, Tas B. How to Predict the Diagnosis of Cutaneous Leishmaniasis in a Non-Endemic Region. Indian J Dermatol. 2022 May-Jun;67(3):232-238.
- 25. Nalçacı M, Karakuş M, Özbel Y, Özbilgin A, Töz S. Increasing the Sensitivity of Leishmania RNA Virus 2 (LRV2) Detection with a Modification in cDNA Synthesis. Turkiye Parazitol Derg. 2022 May 23;46(2):86-90. English.
- 26. Gürses G, Yentür Doni N, Yıldız Zeyrek F, Yiğin A. Typing of Leishmania Species Causing Cutaneous Leishmaniasis by Sybr Green Based ITS-1 Real Time Polymerase Chain Reaction Method. Mikrobiyol Bul. 2022 Apr;56(2):326-338.