Comparison between cutaneous leishmaniasis patients with facial and non-facial lesions

Rotem Yedidia Moser, Shalom Ben-Shimol, Orli Sagi, Amir Horev

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We compared demographic, clinical, treatment, and outcome characteristics of facial cutaneous leishmaniasis (CL) and non-facial CL. Methods: In this retrospective cohort study, polymerase chain reaction confirmed Leishmania major CL patients with ≥2 documented hospital visits, 2014–2019, were included. Results: Overall, 134 patients (34% and 66% with facial and non-facial CL, respectively) were included. Facial CL patients were younger (43% vs. 8% <18 years, P < 0.001), with a higher proportion of females (41% vs. 25%, P = 0.07) compared with non-facial CL. Clinical characteristics, including number and size of lesions and ulcer appearance, were similar in both the groups. Higher paromomycin/methylbenzethonium chloride ointment treatment rates were noted in facial CL (85% vs. 64%, P = 0.02). Intralesional sodium stibogluconate was given to 41% and 53% of facial CL and non-facial CL patients, respectively (P = 0.21). Cryotherapy and surgery were only used in non-facial CL patients (5% and 1% of all CL cases, respectively). Systemic treatment (oral miltefosine, intravenous [IV] sodium stibogluconate, IV liposomal amphotericin B) was used in <5% of the cases in both the groups. Overall, 84% of patients showed signs of improvement, including decreased lesion size or clinical improvement in 73% and 75% of patients, respectively. Only 5% of all cases healed without scarring. Outcome rates were similar in both groups. Conclusions: Facial CL patients were younger and received more frequently Leishmania-specific topical treatment than non-facial CL patients. In contrast, the two groups were similar regarding clinical characteristics and outcome. These findings suggest differences in disease severity perception by patients and physicians.

Original languageEnglish
Pages (from-to)1109-1113
Number of pages5
JournalInternational Journal of Dermatology
Volume60
Issue number9
DOIs
StatePublished - 1 Sep 2021
Externally publishedYes

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