Because CL can mimic many other skin diseases, early diagnosis and early treatment are very important to prevent complications and spread of the disease. The fastest and easiest diagnostic method is the leishmanial smear. The most common treatment is the use of local or systemic pentavalent antimony compounds.
BackgroundAtopic dermatitis, a chronic recurrent disease, is frequently encountered in clinical practice. In the last 30 years, the prevalence of atopic dermatitis has rapidly increased due to industrialization. Therefore, there have been attempts in recent years to find new ways of treating and preventing atopic dermatitis.ObjectiveIn this double-blind, randomized, placebo-controlled study, a combination of Bifidobacterium bifidum, Lactobacillus acidophilus, Lactobacillus casei, and Lactobacillus salivarius strains were evaluated in the treatment of atopic dermatitis in pediatric patients.MethodsForty pediatric patients (23 males and 17 females) aged 1~13 years were enrolled. One eligible individual who was approached declined to participate. The probiotic group was administered a probiotic complex containing B. bifidum, L. acidophilus, L. casei, and L. salivarius for 8 weeks. The placebo group, on the other hand, was administered skim milk powder and dextrose. All of the parameters including serum cytokines, eosinophil cationic protein), SCORing Atopic Dermatitis (SCORAD) index, and total serum immunoglobulin E (IgE) were measured in both the probiotic group and the placebo group at the end of 8 weeks.ResultsProbiotic intervention in pediatric atopic dermatitis patients effectively reduced the SCORAD index and serum cytokines interleukin (IL)-5, IL-6, interferon (IFN)-γ, and total serum IgE levels, but did not reduce levels of serum cytokines IL-2, IL-4, IL-10, ECP, or tumor necrosis factor-α (TNF-α) compared to the placebo group.ConclusionOur study found probiotics to be effective in reducing atopic dermatitis patients' SCORAD index, serum IL-5, IL-6, IFN-γ, and total serum IgE levels but not effective in reducing serum IL-2, IL-4, IL-10, ECP, or TNF-α levels.
ÖZETKutanöz leishmaniasis, deride uzun süren nodülo-ülseratif yaralarla seyredip atrofik sikatrisle iyileşen Leishmania türü protozoon parazitlerin oluşturduğu bir hastalık tablosudur. Hastalık yüzyıllardır ülkemizde tanınmakta olup Urfa Çıbanı, Antep çıbanı, yıl çıbanı, Halep Çıbanı, Şark Çıbanı, güzellik yarası gibi değişik adlarla adlandırılmaktadır. Güneydoğu Anadolu Bölgesi'nde hastalık etkeninin Leishmania tropica, Doğu Akdeniz Bölgesi'nde ise Leishmania infantum ve Leishmania tropica olduğu bilinmektedir. Kutanöz leishmaniasis ülkemizde ihbarı zorunlu bir hastalık olup Sağlık Bakanlığı verilerine göre 1990-2010 yılları arasında ülkemizde toplam 46.003 yeni olgu saptanmış, bu olguların %96'sı Şanlıurfa, Adana, Osmaniye, Hatay, Diyarbakır, İçel ve Kahramanmaraş illerinden bildirilmiştir. Son 20 yıldaki toplam olguların ortalama %45'inin Şanlıurfa'dan bildirilmekle birlikte son yıllarda bu oranın giderek azaldığı ve diğer bölgelerin oranlarının arttığı görülmektedir. Kentler arası ulaşı-mın kolaylaşması, yolculukların artması, çeşitli nedenlerle kentlere göçlerin artışına paralel olarak yetersiz altyapı ve sağlıksız konutlarda barınma gibi faktörlerin yıllardır Güneydoğu Anadolu'da sınırlı yerleşim gösteren hastalığın yayılımındaki en önemli belirleyiciler olduğu düşünülmekte-dir. Ülkemizde özellikle ana kaynak olduğu düşünülen hastaların (antroponotik KL) tedavi edilmemesinin yanı sıra, vektöre (hastalığı taşıyan kum sineklerine) kalıcı insektisit uygulamasının etkin ve yeterli yapılamaması da hastalığın yaygınlaşmasında önemli rol oynamaktadır. Bütün bunlar göz önüne alındığında hastalığın hastalar ve sağlık kurumları tarafından ihmal edilmesi de yayılımın artmasında rol oynayan etkenler arasında düşünülebilir. Sağlık Bakanlığı tarafından bilim insanlarının katılımı ile 2011 yılında hazırlanan Leishmaniasis Stratejik Planının da uygulanmaya konulması ile mücadelenin daha etkili hale geleceği düşünülmektedir. (Turkiye Parazitol Derg 2012; 36: 121-9)
BackgroundCutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking.Methodology/Principal FindingsIn this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6–10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0–5 year and 11–15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0–5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0–5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0–5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6–15 years old.Conclusions/SignificanceWe report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0–5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to intralesional treatment and highlighting the need for more effective therapeutic strategies against CL.
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